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NPI Code Detail

MEDICARE: MRS. TINA MARIE SIMS LMSW CAADC BSW

MEDICARE: MRS. TINA MARIE SIMS LMSW CAADC BSW
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
2171100000XAcupuncturist12942MI
31041C0700XClinical Social Worker6801092454MI

General Provider Information

NPI Number : 1952676181
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TINA MARIE SIMS LMSW CAADC BSW
Provider Business Mailing Address
First Line : 1109 S CHIMNEY HILL DR
Second Line :
City : DEWITT
State : MI
Zip : 48820-9573
Country : US
Telephone Number : 517-668-0312
Fax Number :
Provider Business Practice Location Address
First Line : 4902 S CEDAR ST
Second Line :
City : LANSING
State : MI
Zip : 48910-5474
Country : US
Telephone Number : 517-394-7867
Fax Number : 517-394-7867
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2012
Last Update Date : 03/17/2018

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