Healthcare Provider Details

I. General information

NPI: 1568052041
Provider Name (Legal Business Name): BRIDGIT SIMS LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2021
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4219 HANOVER PIKE BLDG B
MANCHESTER MD
21102-1414
US

IV. Provider business mailing address

4219 HANOVER PIKE BLDG B
MANCHESTER MD
21102-1414
US

V. Phone/Fax

Practice location:
  • Phone: 410-861-0616
  • Fax:
Mailing address:
  • Phone: 410-861-0616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC14985
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC018798
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: