Provider Demographics
NPI:1154443216
Name:SIMS, LORRAINE DALE (MA, LLP, LPC)
Entity Type:Individual
Prefix:MRS
First Name:LORRAINE
Middle Name:DALE
Last Name:SIMS
Suffix:
Gender:F
Credentials:MA, LLP, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 445
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-0445
Mailing Address - Country:US
Mailing Address - Phone:810-245-3885
Mailing Address - Fax:810-667-6459
Practice Address - Street 1:5914 N LAPEER RD
Practice Address - Street 2:
Practice Address - City:NORTH BRANCH
Practice Address - State:MI
Practice Address - Zip Code:48461-9778
Practice Address - Country:US
Practice Address - Phone:810-245-3885
Practice Address - Fax:810-667-6459
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401004837101Y00000X
MI6301007280103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI11580952OtherCAQH