Healthcare Provider Details

I. General information

NPI: 1063980787
Provider Name (Legal Business Name): SIERRA STYPA LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2018
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11565 PEARL RD
STRONGSVILLE OH
44136-3356
US

IV. Provider business mailing address

1440 FORD RD
LYNDHURST OH
44124-1470
US

V. Phone/Fax

Practice location:
  • Phone: 440-846-0862
  • Fax:
Mailing address:
  • Phone: 440-623-9219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2405606
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: