Provider Demographics
NPI:1457891103
Name:SIMS, LATONIA (LICSW)
Entity Type:Individual
Prefix:MS
First Name:LATONIA
Middle Name:
Last Name:SIMS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2021
Mailing Address - Street 2:
Mailing Address - City:GARDENDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35071-1880
Mailing Address - Country:US
Mailing Address - Phone:205-213-7049
Mailing Address - Fax:205-278-8755
Practice Address - Street 1:1211 28TH ST S STE 101
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1822
Practice Address - Country:US
Practice Address - Phone:205-607-2331
Practice Address - Fax:205-278-8755
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1347-4025C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical