Provider Demographics
NPI:1871036467
Name:SIMMS, TREVA MICHELLE
Entity Type:Individual
Prefix:
First Name:TREVA
Middle Name:MICHELLE
Last Name:SIMMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 S ALEXANDER ST APT C06
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-6771
Mailing Address - Country:US
Mailing Address - Phone:504-470-4133
Mailing Address - Fax:
Practice Address - Street 1:5640 READ BLVD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-3140
Practice Address - Country:US
Practice Address - Phone:504-245-2440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-30
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health