Provider Demographics
NPI:1336204114
Name:SIERRA COUNSELING & NEUROTHERAPY, LLC
Entity Type:Organization
Organization Name:SIERRA COUNSELING & NEUROTHERAPY, LLC
Other - Org Name:SIERRA COUNSELING & NEUROTHERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:TUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-885-7717
Mailing Address - Street 1:844 W NYE LN STE 201
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-1570
Mailing Address - Country:US
Mailing Address - Phone:775-885-7717
Mailing Address - Fax:775-283-0231
Practice Address - Street 1:844 W NYE LN STE 201
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-1570
Practice Address - Country:US
Practice Address - Phone:775-885-7717
Practice Address - Fax:775-283-0231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV00158-L101YA0400X
NV924101YA0400X
NVPS175103TC0700X
NV0962106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100507929Medicaid