Provider Demographics
NPI:1083928147
Name:SIMS, COLBERT LEE III (MS)
Entity Type:Individual
Prefix:MR
First Name:COLBERT
Middle Name:LEE
Last Name:SIMS
Suffix:III
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1970 AQUARIUS CT
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32766-5060
Mailing Address - Country:US
Mailing Address - Phone:407-529-9976
Mailing Address - Fax:
Practice Address - Street 1:1350 N ORANGE AVE STE 223
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4955
Practice Address - Country:US
Practice Address - Phone:407-644-4367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-31
Last Update Date:2010-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health