Healthcare Provider Details

I. General information

NPI: 1326874215
Provider Name (Legal Business Name): BAILEY SIMS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2024
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 MILLERSVILLE RD STE 200C
INDIANAPOLIS IN
46205-2987
US

IV. Provider business mailing address

5139 ANNETTE ST
INDIANAPOLIS IN
46208-2470
US

V. Phone/Fax

Practice location:
  • Phone: 765-387-7148
  • Fax:
Mailing address:
  • Phone: 317-432-6880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: BAILEY SIMS
Title or Position: OWNER
Credential: LMHC
Phone: 317-432-6880