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General NPI Number Information
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NPI Number | 1679117204
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Entity Type | Organization
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Legal Business Name | SEARS COUNSELING, LLC
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Dates
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Enumeration Date | 11/06/2019
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Last Update Date | 11/06/2019
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Provider Practice Location Address
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Address Line | 1000 NEW SEA ISLAND RD APT 54
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City | SAINT SIMONS ISLAND
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State | GA
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Zip | 31522-2443
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Country | US
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Telephone | 678-723-8307
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 NEW SEA ISLAND RD APT 54
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City | SAINT SIMONS ISLAND
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State | GA
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Zip | 31522-2443
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROFESSIONAL COUNSELOR
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Name | JENNIFER SEARS
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Credential | LPC
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Telephone | 912-286-4398
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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