Healthcare Provider Details
I. General information
NPI: 1477572147
Provider Name (Legal Business Name): ARMETHIA LOUISE SIMS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15370 LEVAN RD STE. 2
LIVONIA MI
48154-1903
US
IV. Provider business mailing address
5900 BRIDGE RD APT. 104
YPSILANTI MI
48197-8200
US
V. Phone/Fax
- Phone: 734-744-0170
- Fax: 734-744-0171
- Phone: 734-730-2074
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 6401007616 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: