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NPI Code Detail

MEDICARE: SIERRA WARD

MEDICARE: SIERRA WARD
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 Counselor

General Provider Information

NPI Number : 1780523969
Entity Type Code : Individual
Provider Name (Legal Business Name) : SIERRA WARD
Provider Business Mailing Address
First Line : 750 BROADWAY AVE E
Second Line :
City : MATTOON
State : IL
Zip : 61938-4610
Country : US
Telephone Number : 217-238-5700
Fax Number :
Provider Business Practice Location Address
First Line : 750 BROADWAY AVE E
Second Line :
City : MATTOON
State : IL
Zip : 61938-4610
Country : US
Telephone Number : 217-238-5700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2026
Last Update Date : 03/25/2026

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Directions to “ SIERRA WARD ” Practice Location

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