MR. KENNETH SIMPSON SR. (NPI# 1477089290) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477089290 |
| Entity Type | Individual |
| Full Name | MR. KENNETH SIMPSON SR. |
| Credential | LCSW |
| Practice Address |
4747 Lincoln Mall Dr Ste 412 Matteson IL 60443-3821 |
| Practice Telephone | 7083006977 |
| Practice Fax Number | 7083006978 |
| Mailing Telephone | 7083006977 |
| Mailing Fax Number | 7083006978 |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2019-09-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
23393 | IL | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
149.021624 | IL | Behavioral Health & Social Service Providers |
| N | 405300000X | Prevention Professional | 22083 | IL | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 8000 Melton Rd, Gary, IN 464033114 | 2199384651 | 2199384679 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831535707 | Kenneth James Simpson | Anesthesiology | 13909 E Chenango Dr, Aurora, CO 80015-3909 | 2013-05-17 |
| 1811050875 | Kenneth Roger Simpson | Chiropractor | 101 Chase Ct, Ste B, Milledgeville, GA 31061-7188 | 2006-12-19 |
| 1093352700 | Kenneth Ray Simpson | Marriage & Family Therapist | 250 Executive Park Blvd Ste 4900, San Francisco, CA 94134-3335 | 2019-12-02 |
| 1447736624 | Kenneth Simpson | Pharmacist | 60 Hampton Village Plz, Saint Louis, MO 63109-2127 | 2018-07-11 |
| 1548331119 | Kenneth Ray Simpson | Chiropractor | 139 S Main St, Milton Freewater, OR 97862-1354 | 2006-11-13 |
| 1679530323 | Kenneth Roberts Simpson Jr. | Family Medicine | 7255 Hanover Green Dr, Mechanicsville, VA 23111-1706 | 2006-04-27 |
| Street Address |
4747 LINCOLN MALL DR STE 412 |
| City | MATTESON |
| State | IL |
| Zip Code | 60443-3821 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215392931 | One Direction Forward Inc. | Community/Behavioral Health | 4747 Lincoln Mall Dr Ste 412, Matteson, IL 60443-3821 | 2015-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821642497 | Natalie Donyelle Mitchell | Psychologist | 6202 Vollmer Rd Colin Powell Middle School, Elementary Sd 159, Matteson, IL 60443 | 2019-07-31 |
| 1881199909 | Christopher Anthony Smith | Student in an Organized Health Care Education/Training Program | 5660 Woodgate Dr, Matteson, IL 60443 | 2018-03-29 |
| 1336695253 | Renato Leano | Physical Therapist | 21020 Kostner Avenue, Matteson, IL 60443 | 2016-08-31 |
| 1669826657 | Heredeshee Latrice Taylor | Nurse Practitioner | 3201 Holden Cir, Matteson, IL 60443 | 2016-04-16 |
| 1366713125 | Rosanne Miller Tadsen | Counselor | 6201 Vollmer Rd, Matteson, IL 60443 | 2012-01-25 |
| 1598063281 | Sheri Temple | Occupational Therapist | 3906 212th Place, Matteson, IL 60443 | 2011-03-04 |
| 1013247576 | Sheila M. Pijus | Counselor | 336 Tullamore Ter., Matteson, IL 60443 | 2010-01-06 |
| 1962731190 | Benita Yvette Norwoord | Counselor | 600 Holiday Plaza, Matteson, IL 60443 | 2009-12-17 |
| 1386881654 | Reliance Home Health Services, Inc. | Home Health | 4350 W. Lincoln Hwy #210, Reliance Home Health Services, Inc., Matteson, IL 60443 | 2009-01-08 |
| 1518139286 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 5640 211th St., Matteson, IL 60443 | 2008-04-02 |
| Find all providers in zip 60443 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225695661 | Lisa Gacki | Social Worker | 4747 Lincoln Mall Dr Ste 101, Matteson, IL 60443-3812 | 2019-05-21 |
| 1558762724 | Stefanie Burby | Social Worker | 21141 Governors Hwy Ste 205, Matteson, IL 60443-3810 | 2014-09-08 |
| 1457752826 | Valerie Malone-pitts | Social Worker | 5811 Allemong Dr, Matteson, IL 60443-1107 | 2014-09-04 |
| 1700156593 | Michele Lynnette Edwards | Social Worker | 260 Providence Dr, Matteson, IL 60443-1390 | 2012-01-10 |
| 1053606665 | Pamela A Schmeckpeper | Social Worker | 3710 215th St, 303, Matteson, IL 60443-2757 | 2011-06-10 |
| 1245535269 | Kimberly Patrice Spivey | Social Worker | 5113 Monroe St, Matteson, IL 60443-3072 | 2011-01-22 |
| 1194032672 | Joyce M Allen | Social Worker | 6253 White Birch Ln, Matteson, IL 60443-1429 | 2010-09-07 |
| 1598096547 | Veronica D. Walker-douglas | Social Worker | 4749 Lincoln Mall Dr Ste 202, Matteson, IL 60443-3807 | 2010-01-14 |
| 1366677015 | Williams & Morgan | Social Worker | 110 Lawrence Lane, Matteson, IL 60443-2933 | 2009-05-26 |
| 1780764563 | Janet Marie Gardner | Social Worker | 3322 Savanna Ln, Matteson, IL 60443-4440 | 2006-10-16 |
| Find all providers in MATTESON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.