=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184633265
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DON A. SIMS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/06/2006
-----------------------------------------------------
Last Update Date | 06/26/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1117 E WOOD ST
-----------------------------------------------------
City | PARIS
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38242-4326
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 731-644-1089
-----------------------------------------------------
Fax | 731-644-2173
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1117 E WOOD ST
-----------------------------------------------------
City | PARIS
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38242-4326
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 731-644-1089
-----------------------------------------------------
Fax | 731-644-2173
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. DON A. SIMS
-----------------------------------------------------
Credential | MSSW, LCSW
-----------------------------------------------------
Telephone | 731-644-1089
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | LPC0000000570
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | LSW0000000407
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------