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Individual
MR. KENNETH SIMPSON SR.
Active
Individual
MR. KENNETH SIMPSON SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
23393
IL
1041C0700X
Clinical Social Worker
Primary
149.021624
IL
405300000X
Prevention Professional
22083
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447089290
—
IL
Enumeration date
05/11/2017
Last updated
04/09/2022
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