Provider Demographics
NPI:1104990282
Name:SIME, ANDREA JOY (LCSW)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:JOY
Last Name:SIME
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 S 40TH ST STE 212
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-5248
Mailing Address - Country:US
Mailing Address - Phone:402-441-9280
Mailing Address - Fax:
Practice Address - Street 1:1919 S 40TH ST STE 212
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5248
Practice Address - Country:US
Practice Address - Phone:402-441-9280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE501101YM0800X
NE1001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE68506A010OtherTRICARE
NE052174OtherVALUE OPTIONS #
NE82555OtherBLUE CROSS & BLUE SHIELD
NEP00390674OtherRAILROAD MEDICARE
NE47075636926Medicaid
NE5161OtherMIDLANDS INSURANCE #
NE68506A010OtherTRICARE
NE47075636926Medicaid