Provider Demographics
NPI:1649995903
Name:BROWN, CIERRA NICOLE DAVIS (LPC)
Entity type:Individual
Prefix:
First Name:CIERRA
Middle Name:NICOLE DAVIS
Last Name:BROWN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CIERRA
Other - Middle Name:NICOLE
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:31 PINE GROVE RD # 1009
Mailing Address - Street 2:
Mailing Address - City:LOCUST GROVE
Mailing Address - State:GA
Mailing Address - Zip Code:30248-2561
Mailing Address - Country:US
Mailing Address - Phone:404-822-6115
Mailing Address - Fax:
Practice Address - Street 1:31 PINE GROVE RD # 1009
Practice Address - Street 2:
Practice Address - City:LOCUST GROVE
Practice Address - State:GA
Practice Address - Zip Code:30248-2561
Practice Address - Country:US
Practice Address - Phone:404-477-4327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-10
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC013275101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional