DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: SIERRA J KETCHUM LMSW

MEDICARE: SIERRA J KETCHUM LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker22809-MAR

General Provider Information

NPI Number : 1215771266
Entity Type Code : Individual
Provider Name (Legal Business Name) : SIERRA J KETCHUM LMSW
Provider Business Mailing Address
First Line : 2400 S 48TH ST
Second Line :
City : SPRINGDALE
State : AR
Zip : 72762-6683
Country : US
Telephone Number : 479-750-2020
Fax Number :
Provider Business Practice Location Address
First Line : 2466 S 48TH ST
Second Line :
City : SPRINGDALE
State : AR
Zip : 72762-6683
Country : US
Telephone Number : 479-750-2020
Fax Number : 479-750-2747
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2024
Last Update Date : 04/08/2026

Similar Medicare Providers

1568461887 — OZARK GUIDANCE CENTER, INC
Practice Location Address:
2400 S 48TH ST
SPRINGDALE, AR
72762-6683
Practice Phone: 479-750-2020
Practice Fax: 479-750-4843
1780666495 — DONNA T. ROCHA M.D.
Practice Location Address:
2400 S 48TH ST
SPRINGDALE, AR
72762-6683
Practice Phone: 479-750-2020
Practice Fax: 479-750-4843
1427002229 — ROBYN ELIZABETH BENSON MHPP
Practice Location Address:
2466 S 48TH ST
SPRINGDALE, AR
72762-6683
Practice Phone: 479-750-2020
Practice Fax: 479-751-4346
1780638742 — RETHA WOODS GREGORY LPC
Practice Location Address:
2400 S 48TH ST
SPRINGDALE, AR
72762-6683
Practice Phone: 479-750-2020
Practice Fax: 479-751-4346
1417902123 — TRAVIS JENKINS MD
Practice Location Address:
2400 S 48TH ST
SPRINGDALE, AR
72762-6683
Practice Phone: 479-750-2020
Practice Fax: 479-750-4843
1710932397 — EDWIN CARROLL JONES MD
Practice Location Address:
2400 S 48TH ST
SPRINGDALE, AR
72762-6683
Practice Phone: 479-750-2020
Practice Fax: 479-751-4346

Directions to “ SIERRA J KETCHUM LMSW” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.