Provider Demographics
NPI:1528695863
Name:SIMPSON, SONJA L (MS)
Entity type:Individual
Prefix:
First Name:SONJA
Middle Name:L
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1242 W AIRDRIE ST APT 3
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-3707
Mailing Address - Country:US
Mailing Address - Phone:484-844-9003
Mailing Address - Fax:
Practice Address - Street 1:1242 W AIRDRIE ST APT 3
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-3707
Practice Address - Country:US
Practice Address - Phone:484-844-9003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-26
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
PABH006433106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty