Provider Demographics
NPI:1942776380
Name:BARNETT GRICE, CIERRA ASHLEY
Entity type:Individual
Prefix:
First Name:CIERRA
Middle Name:ASHLEY
Last Name:BARNETT GRICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1815 RUNNING BROOK RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28214-7614
Mailing Address - Country:US
Mailing Address - Phone:704-840-8397
Mailing Address - Fax:
Practice Address - Street 1:1815 RUNNING BROOK RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28214-7614
Practice Address - Country:US
Practice Address - Phone:704-840-8397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-23
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0175591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1316236458OtherGAC NPI