Provider Demographics
NPI:1689547614
Name:CANNALEY, CIERRA DAWN
Entity type:Individual
Prefix:
First Name:CIERRA
Middle Name:DAWN
Last Name:CANNALEY
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 1:637 ALTON ST
Mailing Address - Street 2:
Mailing Address - City:BEECH GROVE
Mailing Address - State:IN
Mailing Address - Zip Code:46107-1832
Mailing Address - Country:US
Mailing Address - Phone:317-755-7258
Mailing Address - Fax:
Practice Address - Street 1:549 E COUNTY LINE RD STE B
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1068
Practice Address - Country:US
Practice Address - Phone:317-576-3840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor