Healthcare Provider Details

I. General information

NPI: 1093633828
Provider Name (Legal Business Name): SIERRA WELLS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

823 FILMORE AVE
ERIE PA
16505-4127
US

IV. Provider business mailing address

196 AVALON BLVD
JAMESTOWN NY
14701-4306
US

V. Phone/Fax

Practice location:
  • Phone: 814-580-9167
  • Fax:
Mailing address:
  • Phone: 716-720-2097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: