Healthcare Provider Details

I. General information

NPI: 1699320663
Provider Name (Legal Business Name): HEATHER SIMS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2019
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 SOUTHBRIDGE PKWY STE 650
BIRMINGHAM AL
35209-1317
US

IV. Provider business mailing address

421 GARY DR
MOUNT OLIVE AL
35117-3230
US

V. Phone/Fax

Practice location:
  • Phone: 646-941-7645
  • Fax: 929-596-7897
Mailing address:
  • Phone: 205-500-2145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC05104
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: