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NPI Code Detail

MEDICARE: KATHARINE SIMPSON LPCC

MEDICARE: KATHARINE SIMPSON LPCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor4612MN

General Provider Information

NPI Number : 1417775289
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHARINE SIMPSON LPCC
Provider Business Mailing Address
First Line : 4208 PARK GLEN RD
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55416-4758
Country : US
Telephone Number : 612-825-4792
Fax Number :
Provider Business Practice Location Address
First Line : 4208 PARK GLEN RD
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55416-4758
Country : US
Telephone Number : 612-825-4792
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2024
Last Update Date : 10/01/2024

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