MEDICARE: TIFFANY SIMS LPC, NCC

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	101YP2500X	Professional Counselor	3259	MS

General Provider Information

NPI Number	:	1992501662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY SIMS LPC, NCC

Provider Business Mailing Address
First Line	:	747 SARAH STAMPER RD
Second Line	:
City	:	DECATUR
State	:	MS
Zip	:	39327-9502
Country	:	US
Telephone Number	:	601-527-1085
Fax Number	:

Provider Business Practice Location Address
First Line	:	210 S MAIN ST
Second Line	:
City	:	NEWTON
State	:	MS
Zip	:	39345-2613
Country	:	US
Telephone Number	:	601-287-5528
Fax Number	:

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

Provider Enumeration Date	:	02/21/2025
Last Update Date	:	03/17/2026

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