Provider Demographics
NPI:1013778729
Name:SHEAR, TIANA M (MS ED, QMHP)
Entity type:Individual
Prefix:
First Name:TIANA
Middle Name:M
Last Name:SHEAR
Suffix:
Gender:F
Credentials:MS ED, QMHP
Other - Prefix:MRS
Other - First Name:TIANA
Other - Middle Name:M
Other - Last Name:SHEAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:TIANA THOMAS
Mailing Address - Street 1:900 ROYAL HEIGHTS RD STE 1250
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62226-5457
Mailing Address - Country:US
Mailing Address - Phone:618-688-1132
Mailing Address - Fax:
Practice Address - Street 1:900 ROYAL HEIGHTS RD STE 1250
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62226-5457
Practice Address - Country:US
Practice Address - Phone:618-688-1132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health