Provider Demographics
NPI:1912055187
Name:SIMS, VICTOR M SR (LCSW-BACS)
Entity Type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:M
Last Name:SIMS
Suffix:SR
Gender:M
Credentials:LCSW-BACS
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 1525
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70073-1525
Mailing Address - Country:US
Mailing Address - Phone:504-362-9010
Mailing Address - Fax:504-362-9070
Practice Address - Street 1:2550 BELLE CHASSE HWY
Practice Address - Street 2:SUITE 150
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70053-6758
Practice Address - Country:US
Practice Address - Phone:504-362-9010
Practice Address - Fax:504-362-9070
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA75701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA100091237OtherAMERICAN PSYCH SYSTEMS
LA2185187Medicaid