Provider Demographics
NPI:1790382786
Name:SIMS, CORTEZ D (DOCTOROF PHILOSOPHY)
Entity type:Individual
Prefix:MR
First Name:CORTEZ
Middle Name:D
Last Name:SIMS
Suffix:
Gender:M
Credentials:DOCTOROF PHILOSOPHY
Other - Prefix:DR
Other - First Name:CORTEZ
Other - Middle Name:D
Other - Last Name:SIMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DR CORTEZ D SIMS
Mailing Address - Street 1:12865 W ORANGE DR
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-4102
Mailing Address - Country:US
Mailing Address - Phone:520-477-7214
Mailing Address - Fax:
Practice Address - Street 1:9138 E DENNIS ST
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85207-6008
Practice Address - Country:US
Practice Address - Phone:505-805-9203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-03
Last Update Date:2020-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health