Provider Demographics
NPI:1871181529
Name:SIMS, SHELBY QUARLES (LMSW)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:QUARLES
Last Name:SIMS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10504 WISTERIA WAY
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-3167
Mailing Address - Country:US
Mailing Address - Phone:202-421-7997
Mailing Address - Fax:
Practice Address - Street 1:10504 WISTERIA WAY
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-3167
Practice Address - Country:US
Practice Address - Phone:202-421-7997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26689104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty