Provider Demographics
NPI:1477398923
Name:LAWRENCE, KIERA TALEXUS (LCSW-A)
Entity type:Individual
Prefix:MS
First Name:KIERA
Middle Name:TALEXUS
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 DUNSTAN AVE STE B
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-2390
Mailing Address - Country:US
Mailing Address - Phone:984-377-8576
Mailing Address - Fax:
Practice Address - Street 1:415 DUNSTAN AVE STE B
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2390
Practice Address - Country:US
Practice Address - Phone:984-377-8576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0196391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical