Provider Demographics
NPI:1487376430
Name:SIMPSON-VAN BEEK, TYHESIA
Entity type:Individual
Prefix:
First Name:TYHESIA
Middle Name:
Last Name:SIMPSON-VAN BEEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7929 CHURCHILL WAY APT 7110
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-0002
Mailing Address - Country:US
Mailing Address - Phone:319-471-0975
Mailing Address - Fax:
Practice Address - Street 1:7929 CHURCHILL WAY APT 7110
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-0002
Practice Address - Country:US
Practice Address - Phone:319-471-0975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-16
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker