Provider Demographics
NPI:1174008791
Name:SIMS, ALLEN SR (DMIN LBSW)
Entity type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:
Last Name:SIMS
Suffix:SR
Gender:M
Credentials:DMIN LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 EDGAR D NIXON AVE
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36104-4878
Mailing Address - Country:US
Mailing Address - Phone:334-465-1380
Mailing Address - Fax:
Practice Address - Street 1:819 EDGAR D NIXON AVE
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36104-4878
Practice Address - Country:US
Practice Address - Phone:334-263-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-28
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4679B104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker