Provider Demographics
NPI:1538371166
Name:SHEAR, RONALD III (LCSW)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:
Last Name:SHEAR
Suffix:III
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 764
Mailing Address - Street 2:
Mailing Address - City:MANTENO
Mailing Address - State:IL
Mailing Address - Zip Code:60950-0764
Mailing Address - Country:US
Mailing Address - Phone:708-275-0934
Mailing Address - Fax:708-827-0485
Practice Address - Street 1:5320 159TH ST STE 100
Practice Address - Street 2:
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452-3329
Practice Address - Country:US
Practice Address - Phone:708-275-0934
Practice Address - Fax:708-827-0485
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical