Provider Demographics
NPI:1407907017
Name:SIMS, SUSAN V (LMHC, CAP)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:V
Last Name:SIMS
Suffix:
Gender:F
Credentials:LMHC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 W AZEELE ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-2805
Mailing Address - Country:US
Mailing Address - Phone:813-874-0608
Mailing Address - Fax:813-350-9544
Practice Address - Street 1:3601 W AZEELE ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-2805
Practice Address - Country:US
Practice Address - Phone:813-874-0608
Practice Address - Fax:813-350-9544
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH4365101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health