Individual provider Active NPI

Duncan Charles Simpson, LISW, LICDC

  • Clinical Social Worker
  • Tacoma, WA
National Provider Identifier
1346734456
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2103014 Issued in OH
Practice address
9040 Jackson Ave
Tacoma, WA 98431-0001
Phone
(253) 968-1110
NPI assigned
Jun 21, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LICDC.162034 OH
Clinical Social Worker 1041C0700X I.2103014 OH Primary

Addresses

Primary practice location

9040 Jackson Ave
Tacoma, WA 98431-0001

Mailing address

9040 Jackson Ave
Tacoma, WA 98431-0001
Phone (253) 968-1110

Other identifiers 1

IdentifierTypeStateIssuer
03544092MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210923002532 OH Practitioner - Clinical Social Worker 6002213667 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LICDC.162034OHMDAddiction (Substance Use Disorder) Counselor
I.2103014OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Well Cleveland, LLC CurrentSince Oct 5, 2021 Accepting new patients
Signature Health, Inc. CurrentSince Oct 11, 2021 Accepting new patients
Signature Health Inc CurrentSince Oct 11, 2021 Accepting new patients

Locations

3000 Bridge Ave
Ste 4
Cleveland, OH 44113
Phone (216) 282-3838

1662 Mars Ave
Ste 103
Lakewood, OH 44107
Phone (440) 895-7628

21100 Southgate Park Blvd
Maple Heights, OH 44137
Phone (216) 663-6100

7232 Justin Way
Mentor, OH 44060
Phone (440) 488-2855

5338 Meadow Lane Ct
Sheffield Village, OH 44035
Phone (216) 282-3838

38882 Mentor Ave
Willoughby, OH 44094

38876 Mentor Ave
Willoughby, OH 44094
Phone (440) 954-3333

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1346734456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "DUNCAN",
        "middle_name": "CHARLES",
        "credential": "LISW, LICDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-21",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.162034",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2103014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03544092",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.