Provider Demographics
NPI:1396800991
Name:SIMS, DEBBIE D (RN, LCSW, LMFT)
Entity type:Individual
Prefix:MS
First Name:DEBBIE
Middle Name:D
Last Name:SIMS
Suffix:
Gender:F
Credentials:RN, LCSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2808 EASTON RIDGE PL
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46818-8707
Mailing Address - Country:US
Mailing Address - Phone:260-489-5975
Mailing Address - Fax:260-489-5975
Practice Address - Street 1:616 W SUPERIOR ST
Practice Address - Street 2:SUITE 203
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46802-1000
Practice Address - Country:US
Practice Address - Phone:260-426-2255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34002371A1041C0700X
IN35000656A106H00000X
IN28050776A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN077886OtherVALUE OPTIONS