Provider Demographics
NPI:1407104896
Name:SEARS, SHANNA ANNALYN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHANNA
Middle Name:ANNALYN
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 1:16707 E RENO AVE
Mailing Address - Street 2:
Mailing Address - City:CHOCTAW
Mailing Address - State:OK
Mailing Address - Zip Code:73020-7419
Mailing Address - Country:US
Mailing Address - Phone:405-650-4579
Mailing Address - Fax:
Practice Address - Street 1:16707 E RENO AVE
Practice Address - Street 2:
Practice Address - City:CHOCTAW
Practice Address - State:OK
Practice Address - Zip Code:73020-7419
Practice Address - Country:US
Practice Address - Phone:405-650-4579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-16
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK37761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical