Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Keyonta Latrise Johnson- Sims

Individual provider Adult Development & Aging Psychologist · NPI 1417749755

Keyonta Latrise Johnson- Sims is an Adult Development & Aging Psychologist in West Bend, Wisconsin. Practices as a sole proprietor. Licensed in Wisconsin.

Licensed in
WI
In the registry since
2025

Practice location Address checks out

1871 Wallace Lake Rd
West Bend, WI 53090-9074
Phone: (414) 915-1531
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Development & Aging Psychologist (primary) Taxonomy 103TA0700X · Licence 0020200 (WI)

Record details

NPI number1417749755
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 21, 2025
Last updated in NPPESMay 21, 2025
Certification dateMay 21, 2025