Provider Demographics
NPI:1215930755
Name:SIMS, HEIDI M (MSW)
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:M
Last Name:SIMS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MISS
Other - First Name:HEIDI
Other - Middle Name:M
Other - Last Name:HOCKEMEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:5215 N BEND DR
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-1651
Mailing Address - Country:US
Mailing Address - Phone:260-432-5181
Mailing Address - Fax:260-432-5692
Practice Address - Street 1:5215 N BEND DR
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-1651
Practice Address - Country:US
Practice Address - Phone:260-432-5181
Practice Address - Fax:260-432-5692
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33004601A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN049912POtherSIHO
IN000000202537OtherANTHEM BCBS
IN12368OtherPHP