Healthcare Provider Details

I. General information

NPI: 1710875224
Provider Name (Legal Business Name): MARIE SIMS PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2025
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 HENRY AVE, OKAMI COLLECTIVE, SUITE 364
PHILA PA
19129-1141
US

IV. Provider business mailing address

755 W LANCASTER AVE # 1016
BRYN MAWR PA
19010-3401
US

V. Phone/Fax

Practice location:
  • Phone: 215-618-9766
  • Fax: 215-330-4792
Mailing address:
  • Phone: 215-618-9766
  • Fax: 215-330-4792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP032561
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: