Provider Demographics
NPI:1457908907
Name:SMITH, SIERRA AUNDREA (MSW)
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:AUNDREA
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 428
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83877-0428
Mailing Address - Country:US
Mailing Address - Phone:509-214-3335
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 428
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83877-0428
Practice Address - Country:US
Practice Address - Phone:509-214-3335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-20
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X, 171M00000X, 171M00000X
ND62901041C0700X, 1041C0700X
WACG61071418101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No174400000XOther Service ProvidersSpecialist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor