Healthcare Provider Details

I. General information

NPI: 1184630188
Provider Name (Legal Business Name): PAULETTE MARIE SEARS MS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 EAST WALDO BLVD
MANITOWOC WI
54220
US

IV. Provider business mailing address

4555 WEST SCHROEDER DRIVE SUITE 170
MILWAUKEE WI
53223
US

V. Phone/Fax

Practice location:
  • Phone: 920-682-6087
  • Fax: 920-682-6087
Mailing address:
  • Phone: 414-365-3210
  • Fax: 414-365-3225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3228125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: