Michelle Grace Sierra-Kwandham, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11078 Issued in SC

Practice address

18TH Medical Group
Unit 5142
Apo, AP 96368-5142

Phone

(315) 630-4780

NPI assigned

Oct 13, 2011

Last updated

Nov 25, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alliance CBS, Inc.

  • Community/Behavioral Health Agency
  • Brevard, NC
  • NPI 1295972230

  Clinical

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1942585674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 MISSILE AVENUE MINOT AFB ND 58705-5024",
            "address_2": "10 MISSILE AVE",
            "city": "MINO",
            "state": "ND",
            "postal_code": "587055024",
            "telephone_number": "701-723-5633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "MIL",
            "address_1": "18TH MEDICAL GROUP",
            "address_2": "UNIT 5142",
            "city": "APO",
            "state": "AP",
            "postal_code": "963685142",
            "telephone_number": "315-630-4780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45 N Country Club Rd",
            "address_purpose": "LOCATION",
            "city": "Brevard",
            "state": "NC",
            "postal_code": "287128908",
            "country_code": "US",
            "telephone_number": "828-883-9676",
            "fax_number": "828-884-9753",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Wilford Hall Loop",
            "address_2": "JBSA Lackland",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "78256",
            "country_code": "US",
            "telephone_number": "210-292-7361",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "194 MISSILE AVENUE",
            "address_2": "MINOT AFB",
            "address_purpose": "LOCATION",
            "city": "Minot",
            "state": "ND",
            "postal_code": "58705",
            "country_code": "US",
            "telephone_number": "701-723-5633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIERRA-KWANDHAM",
        "first_name": "MICHELLE",
        "middle_name": "GRACE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-13",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C008207",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "11078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.