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Organization

STACIE SEARS LLC

Active
Other names
Black Dog Counseling LLC
Organization subpart
No

Provider details

NPI number
Authorized official
STACIE A. SEARS LCSW (OWNER/PSYCHOTHERAPIST)
(385) 240-4505
Entity
Organization

Contact information

Practice address
2319 S FOOTHILL DR STE 180, SALT LAKE CITY, UT 84109-5403
(385) 240-4505
Mailing address
2126 S YUMA ST, SALT LAKE CITY, UT 84109-1107
(385) 240-4505

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
5473800-3501
UT
251S00000X
Community/Behavioral Health Agency

Other

Enumeration date
11/08/2017
Last updated
03/21/2018
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