Provider Demographics
NPI:1558732073
Name:PEMBERTON, CIARA (MA, LPC)
Entity type:Individual
Prefix:
First Name:CIARA
Middle Name:
Last Name:PEMBERTON
Suffix:
Gender:
Credentials:MA, LPC
Other - Prefix:
Other - First Name:CIARA
Other - Middle Name:
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1620 COTTAGE LN
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-5539
Mailing Address - Country:US
Mailing Address - Phone:504-940-4013
Mailing Address - Fax:
Practice Address - Street 1:9800 4TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-2152
Practice Address - Country:US
Practice Address - Phone:206-302-1200
Practice Address - Fax:877-516-8135
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-09
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator