Provider Demographics
NPI:1144511031
Name:SIMS, FURMAN LEE JR
Entity type:Individual
Prefix:MR
First Name:FURMAN
Middle Name:LEE
Last Name:SIMS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9369 RED ROSE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-6995
Mailing Address - Country:US
Mailing Address - Phone:254-813-5906
Mailing Address - Fax:
Practice Address - Street 1:4085 N RANCHO DR
Practice Address - Street 2:SUITE 120
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-3466
Practice Address - Country:US
Practice Address - Phone:702-349-8258
Practice Address - Fax:702-543-3124
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-26
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1255588216Medicaid