Healthcare Provider Details

I. General information

NPI: 1568390979
Provider Name (Legal Business Name): CHAD STEARS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7441 WALSH RD
MILLINGTON TN
38053-6019
US

IV. Provider business mailing address

7441 WALSH RD
MILLINGTON TN
38053-6019
US

V. Phone/Fax

Practice location:
  • Phone: 480-229-3955
  • Fax:
Mailing address:
  • Phone: 480-229-3955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-24701
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: