Provider Demographics
NPI:1124461884
Name:SEARS, GISELE CORMIER (LMHC)
Entity type:Individual
Prefix:MRS
First Name:GISELE
Middle Name:CORMIER
Last Name:SEARS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 STRATFORD RD
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-1234
Mailing Address - Country:US
Mailing Address - Phone:781-883-8365
Mailing Address - Fax:
Practice Address - Street 1:12 STRATFORD RD
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-1234
Practice Address - Country:US
Practice Address - Phone:781-883-8365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-12
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MA8765101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health