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NPI Code Detail

MEDICARE: MRS. HEATHER SIMS

MEDICARE: MRS. HEATHER SIMS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1003192261
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. HEATHER SIMS
Provider Business Mailing Address
First Line : 3565 TUNNEL HILL RD
Second Line :
City : TUNNEL HILL
State : IL
Zip : 62972-3149
Country : US
Telephone Number : 618-559-0024
Fax Number :
Provider Business Practice Location Address
First Line : 1307 W MAIN ST
Second Line :
City : MARION
State : IL
Zip : 62959-1139
Country : US
Telephone Number : 618-997-5336
Fax Number : 618-993-2969
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2011
Last Update Date : 11/01/2011

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