Provider Demographics
NPI:1053132472
Name:EDMONDS, CIERRA (LCSW-C)
Entity type:Individual
Prefix:
First Name:CIERRA
Middle Name:
Last Name:EDMONDS
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 DAPHNE CT
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-3296
Mailing Address - Country:US
Mailing Address - Phone:410-419-6581
Mailing Address - Fax:
Practice Address - Street 1:6800 WISCONSIN AVE # 1066
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-6105
Practice Address - Country:US
Practice Address - Phone:410-419-6581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-18
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD255181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical