Healthcare Provider Details

I. General information

NPI: 1538162755
Provider Name (Legal Business Name): TOMMYE J SIMS M.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 11/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4334 NW EXPRESSWAY SUITE 266
OKLAHOMA CITY OK
73116-1578
US

IV. Provider business mailing address

PO BOX 721175
OKLAHOMA CITY OK
73172-1175
US

V. Phone/Fax

Practice location:
  • Phone: 405-842-6552
  • Fax: 405-842-6559
Mailing address:
  • Phone: 405-842-6552
  • Fax: 405-842-6559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number076
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number7634811187
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: