Doctor Name: | DR. OMAR TREMAYNE SIMS |
NPI Number: | 1003194713 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD, LCSW |
License Number: | CSW005163 |
Business Practice Address: | 455 N Lumpkin St Athens, GA - 306012744 |
Business Phone Number: | 7063697911 |
Business Fax Number: | 7062089509 |
Mailing Address: | Po Box 1704, ATHENS |
State: | GA |
Postal Code: | 306031704 |
Phone Number: | 7063697911 |
Fax Number: | 7062089509 |
NPI Enumeration Date: | 07/29/2011 |
NPI Last Update Date: | 05/28/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | CSW005163 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |