Healthcare Provider Details

I. General information

NPI: 1851242663
Provider Name (Legal Business Name): CIERA GREEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 S RANGE AVE
DENHAM SPRINGS LA
70726-3623
US

IV. Provider business mailing address

PO BOX 41737
BATON ROUGE LA
70835-1737
US

V. Phone/Fax

Practice location:
  • Phone: 225-304-1282
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPLC11097
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: