Provider Demographics
NPI:1205626678
Name:CREASON, CIERRA BLAKE (BSW, MSW, PEL-SW)
Entity type:Individual
Prefix:MS
First Name:CIERRA
Middle Name:BLAKE
Last Name:CREASON
Suffix:
Gender:F
Credentials:BSW, MSW, PEL-SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ELLIS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:62241-1460
Mailing Address - Country:US
Mailing Address - Phone:618-615-6269
Mailing Address - Fax:
Practice Address - Street 1:110 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ELLIS GROVE
Practice Address - State:IL
Practice Address - Zip Code:62241-1460
Practice Address - Country:US
Practice Address - Phone:618-615-6269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
IL1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No104100000XBehavioral Health & Social Service ProvidersSocial Worker