Provider Demographics
NPI:1164527131
Name:SIMS, DEANNA (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:
Last Name:SIMS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:DEANNA
Other - Middle Name:
Other - Last Name:SIMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:16800 N DALLAS PARKWAY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248
Mailing Address - Country:US
Mailing Address - Phone:972-733-7242
Mailing Address - Fax:972-733-7257
Practice Address - Street 1:16800 N DALLAS PARKWAY
Practice Address - Street 2:SUITE 150
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248
Practice Address - Country:US
Practice Address - Phone:972-733-7242
Practice Address - Fax:972-733-7257
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13866101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX13866OtherDEPT OF HEALTH