Groenewold, Sierra Short

Groenewold, Sierra Short is an sole proprietor health care provider with primary practice located at 111 Nw Larch Ave , Redmond OR 97756-1322. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Groenewold, Sierra Short can be contacted via phone (541) 923-4462.

Contact Information

Primary practice address
111 Nw Larch Ave Redmond OR 97756-1322
Phone: (541) 923-4462
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X C3377 Oregon
Behavioral Health & Social Service Providers / Professional 101YP2500X C3377 Oregon

Profile Details

NPI number 1962711150
LBN Legal business name Groenewold, Sierra Short
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 5th, 2010
Last updated Apr 29th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962711150 NPPES
Oregon MEDICAID 500668371

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