Provider Demographics
NPI:1396490975
Name:GREENE, CIERAH (LPC)
Entity type:Individual
Prefix:
First Name:CIERAH
Middle Name:
Last Name:GREENE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2290 W OREGON AVE # 1087
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19145-4197
Mailing Address - Country:US
Mailing Address - Phone:856-213-2553
Mailing Address - Fax:
Practice Address - Street 1:1236 BRACE RD STE KL
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-3229
Practice Address - Country:US
Practice Address - Phone:856-433-8615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-13
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC01105500101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor