Provider Demographics
NPI:1760495212
Name:SIMS, JEANNIE J (LPC, MHSP)
Entity Type:Individual
Prefix:MRS
First Name:JEANNIE
Middle Name:J
Last Name:SIMS
Suffix:
Gender:F
Credentials:LPC, MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117 E WOOD ST
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-4326
Mailing Address - Country:US
Mailing Address - Phone:731-644-1089
Mailing Address - Fax:731-644-2173
Practice Address - Street 1:1117 E WOOD ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-4326
Practice Address - Country:US
Practice Address - Phone:731-644-1089
Practice Address - Fax:731-644-2173
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000000570101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health