Provider Demographics
NPI:1568119899
Name:SIMS, CHAD DAVID (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:DAVID
Last Name:SIMS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 OLD HUNDRED RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-7341
Mailing Address - Country:US
Mailing Address - Phone:812-764-4128
Mailing Address - Fax:
Practice Address - Street 1:511 OLD HUNDRED RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-7341
Practice Address - Country:US
Practice Address - Phone:812-764-4128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810007733103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical