Provider Demographics
NPI:1053071514
Name:SEARLE, CLETSE GEORGETTE
Entity Type:Individual
Prefix:
First Name:CLETSE
Middle Name:GEORGETTE
Last Name:SEARLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3960 BROADWAY BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-8345
Mailing Address - Country:US
Mailing Address - Phone:469-270-1878
Mailing Address - Fax:469-807-3986
Practice Address - Street 1:3256 SOUTHERN DR STE 461
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-1533
Practice Address - Country:US
Practice Address - Phone:214-385-5445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-26
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health