Healthcare Provider Details

I. General information

NPI: 1093636839
Provider Name (Legal Business Name): CIERRA DIAZ LCSW-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 W MILLBROOK RD STE 217
RALEIGH NC
27609-4482
US

IV. Provider business mailing address

3554 ALDIE CT
RALEIGH NC
27610-6925
US

V. Phone/Fax

Practice location:
  • Phone: 919-283-6083
  • Fax:
Mailing address:
  • Phone: 347-314-0780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP024272
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: