Provider Demographics
NPI:1235858234
Name:LOPEZ-JONES, SIEARA DENISE
Entity Type:Individual
Prefix:
First Name:SIEARA
Middle Name:DENISE
Last Name:LOPEZ-JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SIEARA
Other - Middle Name:DENISE
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:59 HIGH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-0542
Mailing Address - Country:US
Mailing Address - Phone:617-637-2697
Mailing Address - Fax:
Practice Address - Street 1:1 WESTINGHOUSE PLZ STE A216
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02136-2167
Practice Address - Country:US
Practice Address - Phone:617-910-9605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical