Provider Demographics
NPI:1336916394
Name:SIMS, SHIRLEY JOHNSON (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:JOHNSON
Last Name:SIMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 LETOURNEAU CIRCLE
Mailing Address - Street 2:BLDG.# 90311 2ND FLOOR
Mailing Address - City:APO
Mailing Address - State:AA
Mailing Address - Zip Code:32544
Mailing Address - Country:US
Mailing Address - Phone:850-881-5061
Mailing Address - Fax:
Practice Address - Street 1:130 LETOURNEAU CIRCLE
Practice Address - Street 2:BLDG #90311 2ND FLOOR
Practice Address - City:HURLBURT FIELD
Practice Address - State:FL
Practice Address - Zip Code:32544
Practice Address - Country:US
Practice Address - Phone:850-881-5061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-08
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW184351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical