Provider Demographics
NPI:1801256581
Name:SIMS, PAULA
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:SIMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:577 MULBERRY ST
Mailing Address - Street 2:STE. 900
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-2728
Mailing Address - Country:US
Mailing Address - Phone:478-743-8333
Mailing Address - Fax:478-743-8308
Practice Address - Street 1:577 MULBERRY ST
Practice Address - Street 2:STE. 900
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-2728
Practice Address - Country:US
Practice Address - Phone:478-743-8333
Practice Address - Fax:478-743-8308
Is Sole Proprietor?:No
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003632101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional