Provider Demographics
NPI:1821430752
Name:SIMS, BERTHA ANN (LCSWA)
Entity Type:Individual
Prefix:MS
First Name:BERTHA
Middle Name:ANN
Last Name:SIMS
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5309 WHITLEY WAY
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-5467
Mailing Address - Country:US
Mailing Address - Phone:336-337-8465
Mailing Address - Fax:
Practice Address - Street 1:620 GUILFORD COLLEGE RD STE G
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27409-2027
Practice Address - Country:US
Practice Address - Phone:336-292-1588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-19
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0065921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical