MEDICARE: CIERA GREEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	PLC11097	LA

General Provider Information

NPI Number	:	1851242663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CIERA GREEN

Provider Business Mailing Address
First Line	:	PO BOX 41737
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70835-1737
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	103 S RANGE AVE
Second Line	:
City	:	DENHAM SPRINGS
State	:	LA
Zip	:	70726-3623
Country	:	US
Telephone Number	:	225-304-1282
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2026
Last Update Date	:	06/02/2026

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Directions to “ CIERA GREEN ” Practice Location

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