Individual provider Active NPI

Paulette Marie Sears, MS LPC

  • Mental Health Counselor
  • Manitowoc, WI
National Provider Identifier
1184630188
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3228125 Issued in WI
Practice address
115 East Waldo Blvd
Manitowoc, WI 54220
Phone
(920) 682-6087
Fax
(920) 682-6087
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 3228125 WI Primary

Addresses

Primary practice location

115 East Waldo Blvd
Manitowoc, WI 54220

Mailing address

4555 West Schroeder Drive
Suite 170
Milwaukee, WI 53223
Phone (414) 365-3210

Other identifiers 1

IdentifierTypeStateIssuer
40937700MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3228125WIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Behavioral Health Services, LLC Past Accepting new patients
Hall Psychological Services LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184630188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4555 WEST SCHROEDER DRIVE",
            "address_2": "SUITE 170",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53223",
            "telephone_number": "414-365-3210",
            "fax_number": "414-365-3225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 EAST WALDO BLVD",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "54220",
            "telephone_number": "920-682-6087",
            "fax_number": "920-682-6087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEARS",
        "first_name": "PAULETTE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MS LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "3228125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40937700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manitowoc, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.