Provider Demographics
NPI:1053070136
Name:CRIBB, SIERRA ALEXANDRIA (LSW, MPH)
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:ALEXANDRIA
Last Name:CRIBB
Suffix:
Gender:F
Credentials:LSW, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1602 S RINGGOLD ST APT 2
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19145-1313
Mailing Address - Country:US
Mailing Address - Phone:803-201-8379
Mailing Address - Fax:
Practice Address - Street 1:135 S 19TH ST STE 250
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-4906
Practice Address - Country:US
Practice Address - Phone:267-974-7727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW137523104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker