Simpson, Kenneth

Simpson, Kenneth is an individual health care provider with primary practice located at 4747 Lincoln Mall Dr Ste 412 , Matteson IL 60443-3821. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Other Service Providers / Prevention Professional, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Simpson, Kenneth can be contacted via phone (708) 300-6977.

Contact Information

Primary practice address
4747 Lincoln Mall Dr Ste 412 Matteson IL 60443-3821
Phone: (708) 300-6977
Fax: (708) 300-6978
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 23393 Illinois
Other Service Providers / Prevention Professional 405300000X 22083 Illinois
Behavioral Health & Social Service Providers / Clinical 1041C0700X 149.021624 Illinois

Profile Details

NPI number 1477089290
LBN Legal business name Simpson, Kenneth
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date May 11th, 2017
Last updated Apr 9th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477089290 NPPES
Illinois MEDICAID 1447089290

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