Individual
JAY SIMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BSW,
Contact information
Practice address
809 W VINE ST, LIMA, OH 45804-1054
(419) 222-4474
(419) 222-7044
Mailing address
1414 N WEST ST, LIMA, OH 45801-2861
(419) 222-4474
(419) 222-7044
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457734782
—
OH
Enumeration date
07/06/2015
Last updated
07/07/2015
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