Provider Demographics
NPI:1275059453
Name:SIMS, AMY C (MS, LCADC, MAC)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:C
Last Name:SIMS
Suffix:
Gender:F
Credentials:MS, LCADC, MAC
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 444
Mailing Address - Street 2:
Mailing Address - City:CHAPTICO
Mailing Address - State:MD
Mailing Address - Zip Code:20621-0444
Mailing Address - Country:US
Mailing Address - Phone:240-375-1165
Mailing Address - Fax:
Practice Address - Street 1:280 STAFFORD RD
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-3582
Practice Address - Country:US
Practice Address - Phone:410-535-3079
Practice Address - Fax:410-535-2220
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-18
Last Update Date:2022-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2894101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)