Provider Demographics
NPI:1699093195
Name:SHEAR, JOHN JR (LCSW)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:SHEAR
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:JOHN
Other - Middle Name:
Other - Last Name:SHEAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:467 VIRGINIA ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14202-1318
Mailing Address - Country:US
Mailing Address - Phone:716-855-0880
Mailing Address - Fax:716-855-0880
Practice Address - Street 1:467 VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14202-1318
Practice Address - Country:US
Practice Address - Phone:716-855-0880
Practice Address - Fax:716-855-0880
Is Sole Proprietor?:No
Enumeration Date:2010-05-07
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY079875-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical