MEDICARE: LAURIE SIMS FP

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
1	253J00000X	Foster Care Agency	8643	AZ
2	385HR2055X	Child Mental Illness Respite Care	8643	AZ
3	104100000X	Social Worker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134247836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURIE SIMS FP

Provider Business Mailing Address
First Line	:	4541 W STONEMAN DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85086-1442
Country	:	US
Telephone Number	:	623-331-7337
Fax Number	:

Provider Business Practice Location Address
First Line	:	4541 W STONEMAN DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85086-1442
Country	:	US
Telephone Number	:	623-331-7337
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	12/16/2025

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