Provider Demographics
NPI:1588341986
Name:SIERRA COUNSELING AND CONSULTING INC
Entity type:Organization
Organization Name:SIERRA COUNSELING AND CONSULTING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:M
Authorized Official - Last Name:BOCKARIE
Authorized Official - Suffix:
Authorized Official - Credentials:BS, MPH
Authorized Official - Phone:310-703-6296
Mailing Address - Street 1:14100 CHADRON AVE APT 106
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-8241
Mailing Address - Country:US
Mailing Address - Phone:171-459-2188
Mailing Address - Fax:
Practice Address - Street 1:14100 CHADRON AVE APT 106
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-8241
Practice Address - Country:US
Practice Address - Phone:171-459-2188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder