Provider Demographics
NPI:1255437398
Name:MEARS, TED PAUL THOMAS (MSW LICSW)
Entity type:Individual
Prefix:MR
First Name:TED
Middle Name:PAUL THOMAS
Last Name:MEARS
Suffix:
Gender:M
Credentials:MSW LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9600 VETERANS DRIVE
Mailing Address - Street 2:MAIL STOP - 116 HOME
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98493-5000
Mailing Address - Country:US
Mailing Address - Phone:253-583-1727
Mailing Address - Fax:253-589-4067
Practice Address - Street 1:9600 VETERANS DRIVE
Practice Address - Street 2:MAIL STOP - 116 HOME
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98493-5000
Practice Address - Country:US
Practice Address - Phone:253-583-1727
Practice Address - Fax:253-589-4067
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000049371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical