Provider Demographics
NPI:1649400821
Name:LEAR, CAROL MICHELE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:MICHELE
Last Name:LEAR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:SHELLY
Other - Middle Name:
Other - Last Name:LEAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:58 UTICA ST
Mailing Address - Street 2:B
Mailing Address - City:HAMILTON
Mailing Address - State:NY
Mailing Address - Zip Code:13346-1108
Mailing Address - Country:US
Mailing Address - Phone:888-317-2985
Mailing Address - Fax:
Practice Address - Street 1:58 UTICA ST
Practice Address - Street 2:B
Practice Address - City:HAMILTON
Practice Address - State:NY
Practice Address - Zip Code:13346-1108
Practice Address - Country:US
Practice Address - Phone:888-317-2985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY13648103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical