Provider Demographics
NPI:1891755195
Name:SEARS, STEPHANIE MILLER (MA)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:MILLER
Last Name:SEARS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:STEPHANIE
Other - Middle Name:MILLER
Other - Last Name:SEARS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2062 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-2133
Mailing Address - Country:US
Mailing Address - Phone:541-484-6509
Mailing Address - Fax:541-338-9365
Practice Address - Street 1:291 WEST 12TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3409
Practice Address - Country:US
Practice Address - Phone:541-343-4585
Practice Address - Fax:541-338-9365
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORLPCC0318101YP2500X
ORPA5011103T00000X
ORLMFTT0155106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist