Provider Demographics
NPI:1508100827
Name:SEARS, EMILY M (BCBA)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:M
Last Name:SEARS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:M
Other - Last Name:SCHOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:737 E 86TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-1803
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7901 E 88TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256
Practice Address - Country:US
Practice Address - Phone:317-849-5437
Practice Address - Fax:317-842-5911
Is Sole Proprietor?:No
Enumeration Date:2012-11-27
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22005746A235Z00000X
IN1-13-14488103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300013587Medicaid