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General NPI Number Information
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NPI Number | 1023542982
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Entity Type | Individual
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Provider Name | DR. PATRICK SEARS, PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 04/18/2017
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Last Update Date | 12/04/2017
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Provider Practice Location Address
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Address Line | 100 US HIGHWAY 40 FCI GREENVILLE, FEDERAL BUREAU OF PRISONS
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City | GREENVILLE
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State | IL
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Zip | 62246
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Country | US
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Telephone | 618-531-6397
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Fax |
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Provider Business Mailing Address
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Address Line | FEDERAL BUREAU OF PRISONS, 100 U.S. HIGHWAY 40
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City | GREENVILLE
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State | IL
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Zip | 62246-2455
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Country | US
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Telephone | 618-664-6200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2016042040
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071009472
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License Number State | IL
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