MEDICARE: SIERRA N BOYD PLMHP

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	101YM0800X	Mental Health Counselor	13562	NE

General Provider Information

NPI Number	:	1871366617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIERRA N BOYD PLMHP

Provider Business Mailing Address
First Line	:	11809 MARY ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68164-6835
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11809 MARY ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68164-6835
Country	:	US
Telephone Number	:	402-285-3409
Fax Number	:

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

Provider Enumeration Date	:	11/02/2023
Last Update Date	:	12/19/2025

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