Provider Demographics
NPI:1487798146
Name:SIMPSON, ELIZABETH H (MA)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:H
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 STATE ST
Mailing Address - Street 2:
Mailing Address - City:CHARLEVOIX
Mailing Address - State:MI
Mailing Address - Zip Code:49720-1622
Mailing Address - Country:US
Mailing Address - Phone:231-497-9288
Mailing Address - Fax:
Practice Address - Street 1:201 STATE ST FL 2
Practice Address - Street 2:
Practice Address - City:CHARLEVOIX
Practice Address - State:MI
Practice Address - Zip Code:49720-1371
Practice Address - Country:US
Practice Address - Phone:231-497-9288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO373106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO373OtherLMFT