Provider Demographics
NPI:1902561210
Name:DUMYAHN, CIERA ADRIENNE (LPC)
Entity type:Individual
Prefix:
First Name:CIERA
Middle Name:ADRIENNE
Last Name:DUMYAHN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4395 E BRIDLE PATH RD
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-7605
Mailing Address - Country:US
Mailing Address - Phone:928-254-9118
Mailing Address - Fax:
Practice Address - Street 1:707 E MINGUS AVE STE 400
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-3746
Practice Address - Country:US
Practice Address - Phone:928-649-0447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-02
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-23423101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZLAC-18637OtherSTATE OF ARIZONA BOARD OF BEHAVIORAL HEALTH EXAMINERS