Willie M. Simpson Evangelistic Ministries, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

WILLIE M. SIMPSON EVANGELISTIC MINISTRIES, INC.

Doing business as

Crossroads Youth Development Center

Practice address

628 Southside Commercial Pkwy
Jonesboro, GA 30236-8912

Phone

(678) 249-5323

NPI assigned

Jan 2, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Willie M Simpson, REV.

Title

Eecutive Director

Phone

(678) 249-5323

Specialties & licenses 1

Addresses

Other names 1

• Crossroads Youth Development Center Doing business as

Locations

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

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199232000000",
    "number": "1235314733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 LORRAINE LN",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817624",
            "telephone_number": "678-249-5323",
            "fax_number": "770-507-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 SOUTHSIDE COMMERCIAL PKWY",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302368912",
            "telephone_number": "678-249-5323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIE M. SIMPSON EVANGELISTIC MINISTRIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-02",
        "last_updated": "2008-01-02",
        "status": "A",
        "authorized_official_last_name": "SIMPSON",
        "authorized_official_first_name": "WILLIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "678-249-5323",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "REV."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crossroads Youth Development Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jayla Amore Williams
• Melinda Williams
• Nikita Williams
• Terri Anderson Williams, RN
• Venneisa Smith Williams, PT005989
• Wish You Well Youth Faith Foundation Inc
• Angel Witcher
• April Diamond Witherspoon, PT, DPT
• Karen L. Woods, CNM
• Lakendria D Woods, LPC

• Community/Behavioral Health Agency in Jonesboro, GA
• Providers in Jonesboro, GA by specialty
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2008; 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.