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Contact Information

KEYONTA L JOHNSON SIMS
1871 WALLACE LAKE RD
WEST BEND, WI53090-9074
 Phone: 414-915-1531
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Adult Development & Aging

103TA0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for KEYONTA L JOHNSON SIMS · (Female)

NPI Number 1417749755
Status Active
Credentials
Entity Individual
Enumeration date 05/21/2025
Last updated 05/21/2025 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • WI License # 0020200
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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