Healthcare Provider Details

I. General information

NPI: 1295546521
Provider Name (Legal Business Name): BRIDGET L SIMS LGPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2025
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

177 ADMIRAL COCHRANE DR STE 130
ANNAPOLIS MD
21401-7307
US

IV. Provider business mailing address

2407 OLD MYSTIC CT
CROFTON MD
21114-3232
US

V. Phone/Fax

Practice location:
  • Phone: 410-266-3058
  • Fax:
Mailing address:
  • Phone: 208-863-2482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGP16045
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: