Healthcare Provider Details

I. General information

NPI: 1053279018
Provider Name (Legal Business Name): CIERA SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 US OVAL STE 100
PLATTSBURGH NY
12903-5901
US

IV. Provider business mailing address

22 US OVAL STE 218
PLATTSBURGH NY
12903-5902
US

V. Phone/Fax

Practice location:
  • Phone: 518-563-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number41620
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: