Provider Demographics
NPI:1225497399
Name:SIERRA, ENEIDA (LPC, CCTP, NCC)
Entity Type:Individual
Prefix:MS
First Name:ENEIDA
Middle Name:
Last Name:SIERRA
Suffix:
Gender:F
Credentials:LPC, CCTP, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5908 OLD AVE
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23605-2122
Mailing Address - Country:US
Mailing Address - Phone:267-356-8880
Mailing Address - Fax:
Practice Address - Street 1:5908 OLD AVE
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23605-2122
Practice Address - Country:US
Practice Address - Phone:267-356-8880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-18
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010469101Y00000X
NJ37AC00262500106H00000X
VA0701012024101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist