MEDICARE: LEANNE SIM

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	221700000X	Art Therapist	16LP00027200	NJ
2	101YM0800X	Mental Health Counselor	100686	TX

General Provider Information

NPI Number	:	1457202095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEANNE SIM

Provider Business Mailing Address
First Line	:	3323 PINE NEEDLE CIR
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-1147
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3323 PINE NEEDLE CIR
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-1147
Country	:	US
Telephone Number	:	737-341-1914
Fax Number	:

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

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

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Directions to “ LEANNE SIM ” Practice Location

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