Provider Demographics
NPI:1912245671
Name:DRAINE, CIERA N (LCSW)
Entity Type:Individual
Prefix:
First Name:CIERA
Middle Name:N
Last Name:DRAINE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 84
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MS
Mailing Address - Zip Code:39163
Mailing Address - Country:US
Mailing Address - Phone:870-972-4939
Mailing Address - Fax:870-972-4911
Practice Address - Street 1:DR ARENIA C MALLORY COMMUNITY HEALTH CENTER
Practice Address - Street 2:17280 HIGHWAY 17 S
Practice Address - City:LEXINGTON
Practice Address - State:MS
Practice Address - Zip Code:39095
Practice Address - Country:US
Practice Address - Phone:662-834-1857
Practice Address - Fax:870-972-4911
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-30
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSC79341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical