| Sierra Life Coaching | |
|
122 Sw Crescent Ave Port St Lucie FL 34984-4327 | |
| (561) 373-0880 | |
| Not Available |
| Full Name | Sierra Life Coaching |
|---|---|
| Speciality | Social Worker |
| Location | 122 Sw Crescent Ave, Port St Lucie, Florida |
| Authorized Official Name and Position | Susana Lopez-sierra (OWNER/PRESIDENT) |
| Authorized Official Contact | 5613730880 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sierra Life Coaching 122 Sw Crescent Ave Port St Lucie FL 34984-4327 Ph: (561) 373-0880 | Sierra Life Coaching 122 Sw Crescent Ave Port St Lucie FL 34984-4327 Ph: (561) 373-0880 |
| NPI Number | 1689302390 |
|---|---|
| Provider Enumeration Date | 08/10/2022 |
| Last Update Date | 09/07/2022 |
| Certification Date | 09/07/2022 |
| Medicare PECOS PAC ID | 9032595608 |
|---|---|
| Medicare Enrollment ID | O20221005001189 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689302390 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Susana Lopez Sierra |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790024289 PECOS PAC ID: 8325424930 Enrollment ID: I20221005002686 |
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