Provider Demographics
NPI:1659069623
Name:WHITE, CIERRA MONEE
Entity Type:Individual
Prefix:
First Name:CIERRA
Middle Name:MONEE
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 WILLIAM AVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80905-2326
Mailing Address - Country:US
Mailing Address - Phone:719-675-7300
Mailing Address - Fax:
Practice Address - Street 1:660 SOUTHPOINTE CT STE 200
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-3874
Practice Address - Country:US
Practice Address - Phone:719-465-2582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional