MEDICARE: DANIELLE NICOLE SIMPSON BCBA

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	106S00000X	Behavior Technician	RBT-19-86504	FL
2	103K00000X	Behavior Analyst	BACB486994	FL

General Provider Information

NPI Number	:	1801566104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE NICOLE SIMPSON BCBA

Provider Business Mailing Address
First Line	:	4620 N SR7
Second Line	:	SUITE 300
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33319
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2895 HUELAND POND BLVD STE 205
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33543-7667
Country	:	US
Telephone Number	:	561-609-0770
Fax Number	:

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

Provider Enumeration Date	:	09/17/2021
Last Update Date	:	04/09/2026

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