Latresa Renee Sims, is a
Technician - Attendant Care Provider based in Portage, Indiana. Latresa Renee Sims is licensed to practice in * (Not Available) (license number ) and her current practice location is
1777 Armstrong St. Suite C., Portage, Indiana. She can be reached at her office (for appointments etc.) via phone at
(219) 841-9166.
NPI number for Latresa Renee Sims is 1366041121 and her current mailing address is 1777 Armstrong St. Suite C., Portage, Indiana. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1366041121.
Healthcare Provider's Profile
| Full Name | Latresa Renee Sims |
|---|
| Gender | Female |
|---|
| Speciality | Technician - Attendant Care Provider |
|---|
| Location | 1777 Armstrong St. Suite C., Portage, Indiana |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1366041121
- Provider Enumeration Date: 10/22/2020
- Last Update Date: 05/20/2025
Medical Identifiers
Medical identifiers for Latresa Renee Sims such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1366041121 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103T00000X | Psychologist | 39004364A (Indiana) | Secondary |
| 103TC2200X | Psychologist - Clinical Child & Adolescent | 39004364A (Indiana) | Secondary |
| 320900000X | Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities | (* (Not Available)) | Secondary |
| 3747P1801X | Technician - Personal Care Attendant | (* (Not Available)) | Secondary |
| 3747A0650X | Technician - Attendant Care Provider | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Latresa Renee Sims is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Latresa Renee Sims,
1777 Armstrong St. Suite C.,
Portage, IN 46368
Ph: (219) 841-9166 | Latresa Renee Sims,
1777 Armstrong St. Suite C.,
Portage, IN 46368
Ph: (219) 841-9166 |
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