Provider Demographics
NPI:1003192261
Name:SIMS, HEATHER
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:
Last Name:SIMS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:MORAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3565 TUNNEL HILL RD
Mailing Address - Street 2:
Mailing Address - City:TUNNEL HILL
Mailing Address - State:IL
Mailing Address - Zip Code:62972-3149
Mailing Address - Country:US
Mailing Address - Phone:618-559-0024
Mailing Address - Fax:
Practice Address - Street 1:1307 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959-1139
Practice Address - Country:US
Practice Address - Phone:618-997-5336
Practice Address - Fax:618-993-2969
Is Sole Proprietor?:No
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)