Healthcare Provider Details

I. General information

NPI: 1568059715
Provider Name (Legal Business Name): CIARA HAAS PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CIARA HAAS PMHNP-BC

II. Dates (important events)

Enumeration Date: 12/22/2020
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11660 UPPER GILCHRIST RD
MOUNT VERNON OH
43050-9084
US

IV. Provider business mailing address

11660 UPPER GILCHRIST RD
MOUNT VERNON OH
43050-9084
US

V. Phone/Fax

Practice location:
  • Phone: 740-392-2200
  • Fax:
Mailing address:
  • Phone: 740-392-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN.530464
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberRN.530464
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: