Healthcare Provider Details

I. General information

NPI: 1750791448
Provider Name (Legal Business Name): TISHLINN ANN SIMS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TISHLINN S FOUNTAIN LPC

II. Dates (important events)

Enumeration Date: 05/02/2014
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1799 STUMPF BLVD
TERRYTOWN LA
70056-3950
US

IV. Provider business mailing address

1799 STUMPF BLVD
TERRYTOWN LA
70056-3950
US

V. Phone/Fax

Practice location:
  • Phone: 504-788-6801
  • Fax: 504-788-6815
Mailing address:
  • Phone: 504-788-6833
  • Fax: 504-788-6815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: