Healthcare Provider Details

I. General information

NPI: 1306480512
Provider Name (Legal Business Name): SHARIEE SIMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2019
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5652 RINGWOOD DR UNIT A
HALETHORPE MD
21227-3848
US

IV. Provider business mailing address

5652 RINGWOOD DR UNIT A
HALETHORPE MD
21227-3848
US

V. Phone/Fax

Practice location:
  • Phone: 888-277-2563
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.0501090
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number976226
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701006203
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC10041
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: