Healthcare Provider Details

I. General information

NPI: 1194157636
Provider Name (Legal Business Name): KEITH AARON SIMS LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2013
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2732 W MICHIGAN ST
INDIANAPOLIS IN
46222-3750
US

IV. Provider business mailing address

PO BOX 637764
CINCINNATI OH
45263-7764
US

V. Phone/Fax

Practice location:
  • Phone: 317-554-4600
  • Fax: 317-554-4617
Mailing address:
  • Phone: 317-880-3939
  • Fax: 317-880-0343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34007768A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: