Provider Demographics
NPI:1588667703
Name:SIMS, PRESTON LYNN (MED)
Entity Type:Individual
Prefix:MR
First Name:PRESTON
Middle Name:LYNN
Last Name:SIMS
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:
Other - Last Name:SIMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MED, LMFT, LADC
Mailing Address - Street 1:PO BOX 721175
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73172-1175
Mailing Address - Country:US
Mailing Address - Phone:405-842-6552
Mailing Address - Fax:405-842-6559
Practice Address - Street 1:4334 NW EXPRESSWAY
Practice Address - Street 2:STE 266
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-1578
Practice Address - Country:US
Practice Address - Phone:405-842-6552
Practice Address - Fax:405-842-6559
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2024-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7101YA0400X
OK75106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)