Provider Demographics
NPI:1891248381
Name:SIMS, ERICA (LPC)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:SIMS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24654 N LAKE PLEASANT PKWY # 103-328
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-1359
Mailing Address - Country:US
Mailing Address - Phone:602-777-1268
Mailing Address - Fax:866-251-5468
Practice Address - Street 1:13201 N 35TH AVE STE 5B
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-1231
Practice Address - Country:US
Practice Address - Phone:602-777-1268
Practice Address - Fax:866-251-5468
Is Sole Proprietor?:No
Enumeration Date:2016-08-01
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15992101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ866000472Medicaid