=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932920345
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SIERRA LAVADA ARMSTRONG PEER SUPPORT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/18/2024
-----------------------------------------------------
Last Update Date | 07/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1400 US RT 22 NW
-----------------------------------------------------
City | WASHINGTON COURT HOUSE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43160-8604
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-335-7282
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7213 PRAIRIE RD NW LOT 48
-----------------------------------------------------
City | WASHINGTON COURT HOUSE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43160-9049
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-505-5514
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number | 190762
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 175T00000X
-----------------------------------------------------
Taxonomy Name | Peer Specialist
-----------------------------------------------------
License Number | APS.005424
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------