| Doctor Name: | JOHNATHAN A SIMPSON |
| NPI Number: | 1043540826 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MA |
| License Number: | 001750 |
| Business Practice Address: | 189 Storrs Rd Mansfield Center, CT - 062501683 |
| Business Phone Number: | 8604231016 |
| Business Fax Number: | 8604231109 |
| Mailing Address: | 113 Warner Ave, WORCESTER |
| State: | MA |
| Postal Code: | 016043151 |
| Phone Number: | 8603368761 |
| Fax Number: | |
| NPI Enumeration Date: | 12/30/2009 |
| NPI Last Update Date: | 12/30/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 001750 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |