Basic Information
| Provider Information | |||||||||
| NPI: | 1124547013 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SEARS | ||||||||
| FirstName: | BRIDGET | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MISS | ||||||||
| NameSuffix: | |||||||||
| Credential: | LPC | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 203 E GALBRAITH RD | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452161353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5139480023 | ||||||||
| FaxNumber: | 5139480087 | ||||||||
| Practice Location | |||||||||
| Address1: | 203 E GALBRAITH RD | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452161353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5139480023 | ||||||||
| FaxNumber: | 5139480087 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2017 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | CS1001744 | OH | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.