Provider Demographics
NPI:1578847539
Name:BAUER, SIERRA (LMSW)
Entity Type:Individual
Prefix:
First Name:SIERRA
Middle Name:
Last Name:BAUER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 N JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:IOLA
Mailing Address - State:KS
Mailing Address - Zip Code:66749-2327
Mailing Address - Country:US
Mailing Address - Phone:620-365-5715
Mailing Address - Fax:
Practice Address - Street 1:304 N JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:IOLA
Practice Address - State:KS
Practice Address - Zip Code:66749-2327
Practice Address - Country:US
Practice Address - Phone:620-365-5715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-07
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS6504104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker