Provider Demographics
NPI:1669840724
Name:HAIRSTON, SIERRA CHARLANDA (MSW, LCSWA)
Entity Type:Individual
Prefix:MISS
First Name:SIERRA
Middle Name:CHARLANDA
Last Name:HAIRSTON
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 WESTBROOK AVE.
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215
Mailing Address - Country:US
Mailing Address - Phone:336-395-8729
Mailing Address - Fax:336-617-8909
Practice Address - Street 1:1710 WESTBROOK AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-8721
Practice Address - Country:US
Practice Address - Phone:336-395-8729
Practice Address - Fax:336-617-8909
Is Sole Proprietor?:No
Enumeration Date:2015-09-07
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0098761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical