Provider Demographics
NPI:1366118770
Name:SIMS, ELIZABETH WYNETTE (MA, LPC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:WYNETTE
Last Name:SIMS
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8511 GLENN LEIGH DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-2773
Mailing Address - Country:US
Mailing Address - Phone:281-650-7922
Mailing Address - Fax:281-533-8239
Practice Address - Street 1:8511 GLENN LEIGH DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-2773
Practice Address - Country:US
Practice Address - Phone:281-650-7922
Practice Address - Fax:281-533-8239
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-17
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79026101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX373188702Medicaid