Healthcare Provider Details

I. General information

NPI: 1144014978
Provider Name (Legal Business Name): ANDRAIA L SIENKO LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 N MAIN ST STE F
HARRISON AR
72601-2920
US

IV. Provider business mailing address

813 E DANIELS ST
OZARK MO
65721-8658
US

V. Phone/Fax

Practice location:
  • Phone: 870-340-2636
  • Fax:
Mailing address:
  • Phone: 870-204-4499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number13193-M
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: