Provider Demographics
NPI:1649551730
Name:SIMS, JENNIFER (MA)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:SIMS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 S 19TH ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-1852
Mailing Address - Country:US
Mailing Address - Phone:412-596-0822
Mailing Address - Fax:
Practice Address - Street 1:6060 GRAHAM HILL RD
Practice Address - Street 2:
Practice Address - City:FELTON
Practice Address - State:CA
Practice Address - Zip Code:95018-9764
Practice Address - Country:US
Practice Address - Phone:831-252-3252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-01
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005976101YP2500X
CA2584101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional