Healthcare Provider Details

I. General information

NPI: 1902469596
Provider Name (Legal Business Name): JOWANNA PEARL SIMS LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2019
Last Update Date: 11/07/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1909 CUBA AVE STE 5
ALAMOGORDO NM
88310-5646
US

IV. Provider business mailing address

11109 DONA ANA RD
LAS CRUCES NM
88007-6150
US

V. Phone/Fax

Practice location:
  • Phone: 575-489-4616
  • Fax:
Mailing address:
  • Phone: 575-491-1918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCMH0203511
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: