Provider Demographics
NPI:1164176046
Name:SIERRA COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:SIERRA COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMINATA
Authorized Official - Middle Name:
Authorized Official - Last Name:CONTEH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:703-831-7403
Mailing Address - Street 1:13000 HARBOR CENTER DR STE 356
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-2846
Mailing Address - Country:US
Mailing Address - Phone:703-831-7403
Mailing Address - Fax:703-991-6005
Practice Address - Street 1:13000 HARBOR CENTER DR STE 356
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-2846
Practice Address - Country:US
Practice Address - Phone:703-831-7403
Practice Address - Fax:703-991-6005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-09
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty