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NPI Code Detail

MEDICARE: SIERRA NASH LMHC, NCC, CCMHC

MEDICARE: SIERRA NASH LMHC, NCC, CCMHC
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
1101YM0800XMental Health Counselor008984NY

General Provider Information

NPI Number : 1750825899
Entity Type Code : Individual
Provider Name (Legal Business Name) : SIERRA NASH LMHC, NCC, CCMHC
Provider Business Mailing Address
First Line : 930 GRAND CONCOURSE APT 1F
Second Line :
City : BRONX
State : NY
Zip : 10451-2706
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 930 GRAND CONCOURSE APT 1F
Second Line :
City : BRONX
State : NY
Zip : 10451-2706
Country : US
Telephone Number : 347-862-2034
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2016
Last Update Date : 07/16/2025

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