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NPI Code Detail

MEDICARE: KELSEY HANNAH BUSH SIMS

MEDICARE: KELSEY HANNAH BUSH SIMS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorOR

General Provider Information

NPI Number : 1093682130
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSEY HANNAH BUSH SIMS
Provider Business Mailing Address
First Line : 65920 OLD BEND REDMOND HWY
Second Line :
City : BEND
State : OR
Zip : 97703-7907
Country : US
Telephone Number : 541-480-7057
Fax Number :
Provider Business Practice Location Address
First Line : 65920 OLD BEND REDMOND HWY
Second Line :
City : BEND
State : OR
Zip : 97703-7907
Country : US
Telephone Number : 541-480-7057
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2025
Last Update Date : 10/22/2025

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Directions to “ KELSEY HANNAH BUSH SIMS ” Practice Location

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