MEDICARE: KATHLEEN SIMPSON LSW

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
1	104100000X	Social Worker	33007741A	IN

General Provider Information

NPI Number	:	1710423322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN SIMPSON LSW

Provider Business Mailing Address
First Line	:	389 SPRINGFIELD CIR
Second Line	:
City	:	GREENWOOD
State	:	IN
Zip	:	46143-7710
Country	:	US
Telephone Number	:	317-833-4999
Fax Number	:

Provider Business Practice Location Address
First Line	:	389 SPRINGFIELD CIR
Second Line	:
City	:	GREENWOOD
State	:	IN
Zip	:	46143-7710
Country	:	US
Telephone Number	:	317-833-4999
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2017
Last Update Date	:	01/06/2017

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