Provider Demographics
NPI:1689714339
Name:SEARS, TONDALAIO (LMSW CASWCM)
Entity Type:Individual
Prefix:
First Name:TONDALAIO
Middle Name:
Last Name:SEARS
Suffix:
Gender:F
Credentials:LMSW CASWCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4706 CANTER ROW
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32526-5078
Mailing Address - Country:US
Mailing Address - Phone:850-293-6968
Mailing Address - Fax:850-505-6591
Practice Address - Street 1:6000 W HWY 98
Practice Address - Street 2:NAVHOSP MEDICAL SVC DIRECTORATE PEDIATRICS DEPT
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32512-0003
Practice Address - Country:US
Practice Address - Phone:850-505-6913
Practice Address - Fax:850-505-6591
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010646831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical