Provider Demographics
NPI:1366598211
Name:SIMPSON, GLENN MURREN (LMHC)
Entity type:Individual
Prefix:MR
First Name:GLENN
Middle Name:MURREN
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4526 VIVIAN DR
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33872-1722
Mailing Address - Country:US
Mailing Address - Phone:863-382-9160
Mailing Address - Fax:863-382-9169
Practice Address - Street 1:4421 SUN N LAKE BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33872-2166
Practice Address - Country:US
Practice Address - Phone:863-314-4357
Practice Address - Fax:863-382-1279
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 2782101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health