Provider Demographics
NPI:1699383331
Name:MARCUS, SIERRA (MA)
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:
Last Name:MARCUS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3305 BRECKINRIDGE BLVD STE 116
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-4932
Mailing Address - Country:US
Mailing Address - Phone:770-495-9775
Mailing Address - Fax:770-495-9745
Practice Address - Street 1:3305 BRECKINRIDGE BLVD STE 116
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-4932
Practice Address - Country:US
Practice Address - Phone:770-495-9775
Practice Address - Fax:770-495-9745
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health