Provider Demographics
NPI:1376829622
Name:CEARLEY, MIRANDA S (LPC, LCMHC, ATR-BC)
Entity type:Individual
Prefix:MRS
First Name:MIRANDA
Middle Name:S
Last Name:CEARLEY
Suffix:
Gender:F
Credentials:LPC, LCMHC, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 144
Mailing Address - Street 2:
Mailing Address - City:RIDGECREST
Mailing Address - State:NC
Mailing Address - Zip Code:28770-0144
Mailing Address - Country:US
Mailing Address - Phone:404-431-0685
Mailing Address - Fax:
Practice Address - Street 1:703 AZALEA AVE
Practice Address - Street 2:
Practice Address - City:BLACK MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28711-2905
Practice Address - Country:US
Practice Address - Phone:404-431-0685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-01
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ATR-BC12-090221700000X
NCLCMHC21272101YM0800X
GALPC8153101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist