Provider Demographics
NPI:1497573166
Name:MCKENZIE, CIERRA (MSW, MBA, RCSWI,CWCM)
Entity type:Individual
Prefix:
First Name:CIERRA
Middle Name:
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:MSW, MBA, RCSWI,CWCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 MAHAN DR STE 3
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5107
Mailing Address - Country:US
Mailing Address - Phone:404-454-5916
Mailing Address - Fax:
Practice Address - Street 1:1100 GREENTREE CT APT J
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32304-1853
Practice Address - Country:US
Practice Address - Phone:404-454-5916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)