Healthcare Provider Details

I. General information

NPI: 1871319376
Provider Name (Legal Business Name): CIARA DAWN FLEMING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2024
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4539 N 22ND ST STE A
PHOENIX AZ
85016-4639
US

IV. Provider business mailing address

2585 E WILCOX DR STE A
SIERRA VISTA AZ
85635-2822
US

V. Phone/Fax

Practice location:
  • Phone: 520-447-8856
  • Fax:
Mailing address:
  • Phone: 520-442-2812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-24754
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: