MEDICARE: SIERRA PETERS MS

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
1	101YP2500X	Professional Counselor	LPCC.0021444	CO

General Provider Information

NPI Number	:	1366123119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIERRA PETERS MS

Provider Business Mailing Address
First Line	:	4850 HAHNS PEAK DR UNIT 200
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80538-6003
Country	:	US
Telephone Number	:	970-422-1060
Fax Number	:

Provider Business Practice Location Address
First Line	:	4850 HAHNS PEAK DR UNIT 200
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80538-6003
Country	:	US
Telephone Number	:	970-422-1060
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2023
Last Update Date	:	04/09/2026

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