Healthcare Provider Details

I. General information

NPI: 1821704834
Provider Name (Legal Business Name): CIERRA SIMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2023
Last Update Date: 10/16/2023
Certification Date: 10/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 CATALPA ST
MONROE LA
71201-7419
US

IV. Provider business mailing address

112 CATALPA ST
MONROE LA
71201-7419
US

V. Phone/Fax

Practice location:
  • Phone: 318-381-8584
  • Fax: 318-388-6893
Mailing address:
  • Phone: 318-381-8584
  • Fax: 318-388-6893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number18059
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: