| Mark Dearing,lcsw Inc | |
|
12412 San Jose Blvd Ste 401 Jacksonville FL 32223-8620 | |
| (904) 348-0343 | |
| Not Available |
| Full Name | Mark Dearing,lcsw Inc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 12412 San Jose Blvd Ste 401, Jacksonville, Florida |
| Authorized Official Name and Position | Mark Richard Dearing (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 9044775678 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark Dearing,lcsw Inc 1703 Mossy Cypress Ln Jacksonville FL 32223-5023 Ph: (904) 477-5678 | Mark Dearing,lcsw Inc 12412 San Jose Blvd Ste 401 Jacksonville FL 32223-8620 Ph: (904) 348-0343 |
| NPI Number | 1003103334 |
|---|---|
| Provider Enumeration Date | 07/07/2011 |
| Last Update Date | 02/25/2020 |
| Certification Date | 02/25/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003103334 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW0000953 (Florida) | Primary |
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