Provider Demographics
NPI:1497410856
Name:SIMS, JENNIFER SHEREE (CADC-R, CRM, PSS)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SHEREE
Last Name:SIMS
Suffix:
Gender:F
Credentials:CADC-R, CRM, PSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3128 SW HAILEY AVE
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-3802
Mailing Address - Country:US
Mailing Address - Phone:541-377-1803
Mailing Address - Fax:
Practice Address - Street 1:17 SW FRAZER AVE STE 282
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-0048
Practice Address - Country:US
Practice Address - Phone:541-278-6330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)