Basic Information
| Provider Information | |||||||||
| NPI: | 1093189169 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SIMPSON | ||||||||
| FirstName: | RONALD | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | JR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4020 CALIFORNIA LN | ||||||||
| Address2: | |||||||||
| City: | OAK RIDGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 712649331 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3182445022 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4951 CENTRAL AVE | ||||||||
| Address2: | |||||||||
| City: | MONROE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 71203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3186496399 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/30/2015 | ||||||||
| LastUpdateDate: | 05/30/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 171M00000X | Y | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.