Judy Simpson, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

21753 Issued in MN

Practice address

24246 Crane Road
White Earth, MN 56591-5659

Phone

(218) 983-4703

NPI assigned

Jan 12, 2024

Last updated

Jan 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1705017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1073384558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22291 STATE HIGHWAY 108",
            "city": "PELICAN RAPIDS",
            "state": "MN",
            "postal_code": "565727705",
            "telephone_number": "701-261-2902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24246 CRANE ROAD",
            "city": "WHITE EARTH",
            "state": "MN",
            "postal_code": "565915659",
            "telephone_number": "218-983-4703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "JUDY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-12",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "21753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Petersen
• Shania Rentschler, LPCC
• Nancy Fredericka Samura
• James M. Schmitt, LSW
• Vanessa Rae Simon, MS, NCC, LPCC
• Sean Simpson, LGSW
• Shannon Mary Jaakola Smith, LMFT
• White Earth Band of Chippewa
• White Earth Band of Chippewa (White Earth Mental Health Program)
• White Earth Band of Chippewa (White Earth Dialysis)

• Clinical Social Worker in White Earth, MN
• Providers in White Earth, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.