Provider Demographics
NPI:1578806592
Name:SIMS, MARTHA LUCIA (MS, LMHC)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:LUCIA
Last Name:SIMS
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2394 RIVER TREE CIR
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-8330
Mailing Address - Country:US
Mailing Address - Phone:407-765-4648
Mailing Address - Fax:
Practice Address - Street 1:781 CIARA CREEK CV STE 1011
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750
Practice Address - Country:US
Practice Address - Phone:407-765-4648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-27
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15159101YM0800X
103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health