Provider Demographics
NPI:1689977043
Name:STEAR, LISA A (LCSW)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:A
Last Name:STEAR
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 1:115 E DIAMOND ST
Mailing Address - Street 2:
Mailing Address - City:BYRON
Mailing Address - State:IL
Mailing Address - Zip Code:61010-9372
Mailing Address - Country:US
Mailing Address - Phone:309-333-1180
Mailing Address - Fax:815-234-5580
Practice Address - Street 1:115 E DIAMOND ST
Practice Address - Street 2:
Practice Address - City:BYRON
Practice Address - State:IL
Practice Address - Zip Code:61010-9372
Practice Address - Country:US
Practice Address - Phone:309-333-1180
Practice Address - Fax:815-234-5580
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0144391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical