Provider Demographics
NPI:1184732943
Name:SIME, WESLEY ELLWYN (PHD)
Entity type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:ELLWYN
Last Name:SIME
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1919 SOUTH 40TH STREET
Mailing Address - Street 2:SUITE #335
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-5286
Mailing Address - Country:US
Mailing Address - Phone:402-420-2500
Mailing Address - Fax:402-420-2501
Practice Address - Street 1:300 S 68TH STREET PL
Practice Address - Street 2:SUITE #500
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2475
Practice Address - Country:US
Practice Address - Phone:402-434-2730
Practice Address - Fax:402-434-3970
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2017-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE367103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE345680000OtherMAGELLAN MIS GT SITE
NE08057OtherBLUE CROSS & BLUE SHIELD
NE132852OtherVALUE OPTIONS #
NE470774254-26Medicaid
NE08140OtherBLUECROSS BLUESHIELD
NE277047Medicare ID - Type Unspecified
NE470774254-26Medicaid
NE08057OtherBLUE CROSS & BLUE SHIELD
NE277047Medicare ID - Type Unspecified