Provider Demographics
NPI:1780482950
Name:EDWARDS, CIERRA (BSSW, MSW, LCSWA)
Entity type:Individual
Prefix:
First Name:CIERRA
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:
Credentials:BSSW, MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 EXECUTIVE CENTER DR STE 235
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212-8821
Mailing Address - Country:US
Mailing Address - Phone:704-936-0213
Mailing Address - Fax:704-936-0226
Practice Address - Street 1:5500 EXECUTIVE CENTER DR STE 235
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-8821
Practice Address - Country:US
Practice Address - Phone:704-936-0200
Practice Address - Fax:704-936-0226
Is Sole Proprietor?:No
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0218481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical