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General NPI Number Information
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NPI Number | 1699662627
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Entity Type | Organization
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Legal Business Name | SIERRA PATHWAYS, A LICENSED CLINICAL SOCIAL WORKER CORPORATION
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 55 1ST ST
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City | LAKEPORT
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State | CA
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Zip | 95453-4839
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Country | US
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Telephone | 240-994-4926
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1445
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City | COBB
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State | CA
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Zip | 95426-1445
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Country | US
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Telephone | 240-994-4926
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. BROOKE H BRODY
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Credential | PHD, LCSW
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Telephone | 240-994-4926
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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