Healthcare Provider Details

I. General information

NPI: 1710293683
Provider Name (Legal Business Name): SIERA SHERIAR CIOCCI MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2010
Last Update Date: 12/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 MILLSTONE DR STE B
HILLSBOROUGH NC
27278-8776
US

IV. Provider business mailing address

108 N HASSEL ST
HILLSBOROUGH NC
27278-2406
US

V. Phone/Fax

Practice location:
  • Phone: 919-637-4112
  • Fax: 919-245-0147
Mailing address:
  • Phone: 480-760-5775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC007569
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: