1912055187 NPI number — MR. VICTOR M. SIMS SR. LCSW-BACS

Table of content: MR. VICTOR M. SIMS SR. LCSW-BACS (NPI 1912055187)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912055187 NPI number — MR. VICTOR M. SIMS SR. LCSW-BACS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SIMS
Provider First Name:
VICTOR
Provider Middle Name:
M.
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
SR.
Provider Credential Text:
LCSW-BACS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912055187
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/07/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1525
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARRERO
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70073-1525
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-362-9010
Provider Business Mailing Address Fax Number:
504-362-9070

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2550 BELLE CHASSE HWY
Provider Second Line Business Practice Location Address:
SUITE 150
Provider Business Practice Location Address City Name:
GRETNA
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70053-6758
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-362-9010
Provider Business Practice Location Address Fax Number:
504-362-9070
Provider Enumeration Date:
01/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  7570 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100091237 . This is a "AMERICAN PSYCH SYSTEMS" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 2185187 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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