MEDICARE: SIERRA AUNDREA SMITH MSW

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	174400000X	Specialist
2	1041C0700X	Clinical Social Worker	6290	ND
3	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1457908907
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIERRA AUNDREA SMITH MSW

Provider Business Mailing Address
First Line	:	PO BOX 428
Second Line	:
City	:	POST FALLS
State	:	ID
Zip	:	83877-0428
Country	:	US
Telephone Number	:	509-214-3335
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 428
Second Line	:
City	:	POST FALLS
State	:	ID
Zip	:	83877-0428
Country	:	US
Telephone Number	:	509-214-3335
Fax Number	:

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

Provider Enumeration Date	:	08/20/2019
Last Update Date	:	12/01/2025

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