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General NPI Number Information
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NPI Number | 1881711240
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Entity Type | Individual
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Provider Name | CHAD SIMS
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Gender | Male
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 09/05/2008
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Provider Practice Location Address
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Address Line | 2018 WESTERN AVENUE
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City | KNOXVILLE
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State | TN
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Zip | 37921
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Country | US
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Telephone | 865-544-0406
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Fax | 865-544-0480
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Provider Business Mailing Address
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Address Line | DEPARTMENT 888182
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City | KNOXVILLE
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State | TN
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Zip | 37995-8182
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Country | US
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Telephone | 800-355-3565
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Fax | 423-714-2355
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2874 (PROV LIC)
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License Number State | TN
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