Provider Demographics
NPI:1225039134
Name:SIMS, CAROL A (LCSW, PIP)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:A
Last Name:SIMS
Suffix:
Gender:F
Credentials:LCSW, PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 83
Mailing Address - Street 2:
Mailing Address - City:LYNDONVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05851
Mailing Address - Country:US
Mailing Address - Phone:802-748-9501
Mailing Address - Fax:802-748-3420
Practice Address - Street 1:195 INDUSTRIAL PARKWAY
Practice Address - Street 2:NVRH CORNER MEDICAL
Practice Address - City:LYNDONVILLE
Practice Address - State:VT
Practice Address - Zip Code:05851
Practice Address - Country:US
Practice Address - Phone:802-748-9501
Practice Address - Fax:802-748-3420
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1271C1041C0700X
VT089-00012311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051538599OtherBCBS OF ALABAMA NUMBER
AL051538836OtherBCBS FEDERAL NUMBER
ALPIP-401-1271COtherPIP LICENSE
AL1271COtherLCSW
ALPIP-401-1271COtherPIP LICENSE
AL051538836OtherBCBS FEDERAL NUMBER