Healthcare Provider Details

I. General information

NPI: 1801677844
Provider Name (Legal Business Name): CIERA CYRUS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2023
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 SHADY LANE DR
NORWALK OH
44857-2710
US

IV. Provider business mailing address

500 N LEXINGTON SPRING RD APT 93
ONTARIO OH
44906-1254
US

V. Phone/Fax

Practice location:
  • Phone: 567-743-7199
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: