Provider Demographics
NPI:1265950869
Name:SPRUILL, CIARRA (LCSW, LCAS)
Entity type:Individual
Prefix:
First Name:CIARRA
Middle Name:
Last Name:SPRUILL
Suffix:
Gender:F
Credentials:LCSW, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7014 SMITH CORNERS BLVD # 1422
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-3793
Mailing Address - Country:US
Mailing Address - Phone:704-269-8548
Mailing Address - Fax:
Practice Address - Street 1:665 W 4TH ST
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-2701
Practice Address - Country:US
Practice Address - Phone:336-725-8389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-03
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0118841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical