Provider Demographics
NPI:1760007033
Name:WINTERS, SIERRA K (LSW)
Entity Type:Individual
Prefix:MRS
First Name:SIERRA
Middle Name:K
Last Name:WINTERS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:MISS
Other - First Name:SIERRA
Other - Middle Name:K
Other - Last Name:MCENIRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:3 EXECUTIVE DR
Mailing Address - Street 2:
Mailing Address - City:MORRIS PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07950-2155
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:MORRIS PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07950-2155
Practice Address - Country:US
Practice Address - Phone:973-285-0006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-12
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06343200104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker