Healthcare Provider Details

I. General information

NPI: 1457908907
Provider Name (Legal Business Name): SIERRA AUNDREA SMITH MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2019
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 428
POST FALLS ID
83877-0428
US

IV. Provider business mailing address

PO BOX 428
POST FALLS ID
83877-0428
US

V. Phone/Fax

Practice location:
  • Phone: 509-214-3335
  • Fax:
Mailing address:
  • Phone: 509-214-3335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6290
License Number StateND
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: