Healthcare Provider Details

I. General information

NPI: 1134247836
Provider Name (Legal Business Name): LAURIE SIMS FP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4541 W STONEMAN DR
PHOENIX AZ
85086-1442
US

IV. Provider business mailing address

4541 W STONEMAN DR
PHOENIX AZ
85086-1442
US

V. Phone/Fax

Practice location:
  • Phone: 623-331-7337
  • Fax:
Mailing address:
  • Phone: 623-331-7337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number8643
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code385HR2055X
TaxonomyChild Mental Illness Respite Care
License Number8643
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: