Provider Demographics
NPI:1770200628
Name:WOOD, SIERRA CORIN (LSW)
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:CORIN
Last Name:WOOD
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 KINCAID AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-5184
Mailing Address - Country:US
Mailing Address - Phone:223-221-0309
Mailing Address - Fax:
Practice Address - Street 1:705 KINCAID AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-5184
Practice Address - Country:US
Practice Address - Phone:223-221-0309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-21
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW139809101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health