Provider Demographics
NPI:1043275845
Name:SIMS, CAROL ANN (PHD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:SIMS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21500 QUICK FOX LN
Mailing Address - Street 2:
Mailing Address - City:LAYTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20882-1340
Mailing Address - Country:US
Mailing Address - Phone:301-721-8278
Mailing Address - Fax:301-990-6011
Practice Address - Street 1:21500 QUICK FOX LN
Practice Address - Street 2:
Practice Address - City:LAYTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20882-1340
Practice Address - Country:US
Practice Address - Phone:301-721-8278
Practice Address - Fax:301-990-6011
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01959103TA0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD049451800Medicaid
MD001809024OtherHIGHMARK BLUE SHIELD
DC0177-0001OtherCARE FIRST BC/BS
MD884ACAOtherCARE FIRST BC/BS