Provider Demographics
NPI:1861087173
Name:SIMS, MARY R (PHD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:R
Last Name:SIMS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 500
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:IN
Mailing Address - Zip Code:47838-0500
Mailing Address - Country:US
Mailing Address - Phone:812-398-5050
Mailing Address - Fax:
Practice Address - Street 1:6908 SOUTH OLD US HIGHWAY 41
Practice Address - Street 2:MENTAL HEALTH DEPARTMENT
Practice Address - City:CARLISLE
Practice Address - State:IN
Practice Address - Zip Code:47838-0500
Practice Address - Country:US
Practice Address - Phone:812-398-5050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20040317A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical