Provider Demographics
NPI:1720840564
Name:COOPER, CIERA T (LCSW-S)
Entity Type:Individual
Prefix:DR
First Name:CIERA
Middle Name:T
Last Name:COOPER
Suffix:
Gender:F
Credentials:LCSW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1327 ROSEBAY RD
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-2245
Mailing Address - Country:US
Mailing Address - Phone:504-342-8342
Mailing Address - Fax:
Practice Address - Street 1:1327 ROSEBAY RD
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-2245
Practice Address - Country:US
Practice Address - Phone:504-342-8342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX558831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical