Provider Demographics
NPI:1891133880
Name:SEARS, LANDY L (LPC)
Entity Type:Individual
Prefix:
First Name:LANDY
Middle Name:L
Last Name:SEARS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:LANDY
Other - Middle Name:LEE
Other - Last Name:SEARS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCPC, LAC
Mailing Address - Street 1:4856 INNOVATION DR
Mailing Address - Street 2:STE B
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-5540
Mailing Address - Country:US
Mailing Address - Phone:970-494-4200
Mailing Address - Fax:970-613-4475
Practice Address - Street 1:4856 INNOVATION DR
Practice Address - Street 2:STE B
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-5540
Practice Address - Country:US
Practice Address - Phone:970-494-4200
Practice Address - Fax:970-613-4475
Is Sole Proprietor?:No
Enumeration Date:2013-06-12
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0019728101YP2500X
MT13859101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1891133880Medicaid
MT1891133880OtherBLUE CROSS BLUE SHIELD