Provider Demographics
NPI:1821740770
Name:MOHR, SIERRA JO MARIE (LMSW, CADC)
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:JO MARIE
Last Name:MOHR
Suffix:
Gender:F
Credentials:LMSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 3RD AVE SW
Mailing Address - Street 2:
Mailing Address - City:LE MARS
Mailing Address - State:IA
Mailing Address - Zip Code:51031-3449
Mailing Address - Country:US
Mailing Address - Phone:712-541-3495
Mailing Address - Fax:
Practice Address - Street 1:505 5TH ST STE 100
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51101-1510
Practice Address - Country:US
Practice Address - Phone:712-277-2007
Practice Address - Fax:712-277-2189
Is Sole Proprietor?:No
Enumeration Date:2022-01-21
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA113535104100000X
IA21099101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker