Provider Demographics
NPI:1295194637
Name:SIMS, LORI WHITNEY (LCSW)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:WHITNEY
Last Name:SIMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9757 BLUE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BLUE RIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30513-4167
Mailing Address - Country:US
Mailing Address - Phone:706-455-2490
Mailing Address - Fax:706-946-6574
Practice Address - Street 1:9757 BLUE RIDGE DR
Practice Address - Street 2:
Practice Address - City:BLUE RIDGE
Practice Address - State:GA
Practice Address - Zip Code:30513-4167
Practice Address - Country:US
Practice Address - Phone:706-455-2490
Practice Address - Fax:706-946-6574
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-13
Last Update Date:2016-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0057051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical