Provider Demographics
NPI:1225105893
Name:SEARS, TERRI (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:TERRI
Middle Name:
Last Name:SEARS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 MORNING DOVE LN
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-5348
Mailing Address - Country:US
Mailing Address - Phone:916-517-6989
Mailing Address - Fax:
Practice Address - Street 1:1380 LEAD HILL BLVD STE 110
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-2997
Practice Address - Country:US
Practice Address - Phone:916-517-6989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21895174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist