Provider Demographics
NPI:1487338778
Name:SIERRA, MARIELY (MSW)
Entity type:Individual
Prefix:
First Name:MARIELY
Middle Name:
Last Name:SIERRA
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 1:62 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06052-1116
Mailing Address - Country:US
Mailing Address - Phone:860-960-9567
Mailing Address - Fax:
Practice Address - Street 1:602 NEW BRITAIN AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-4033
Practice Address - Country:US
Practice Address - Phone:860-965-6875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health