MEDICARE: SIERRA JOHNSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency
2	101YM0800X	Mental Health Counselor	0704015825	VA

General Provider Information

NPI Number	:	1538840020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIERRA JOHNSON

Provider Business Mailing Address
First Line	:	9273 1ST VIEW ST
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23503-4225
Country	:	US
Telephone Number	:	267-207-0397
Fax Number	:

Provider Business Practice Location Address
First Line	:	9273 1ST VIEW ST
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23503-4225
Country	:	US
Telephone Number	:	267-207-0397
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2023
Last Update Date	:	02/15/2026

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Directions to “ SIERRA JOHNSON ” Practice Location

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