| Doctor Name: | MARK RICHARD DEARING |
| NPI Number: | 1013069137 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | SW0000953 |
| Business Practice Address: | 1555 Kingsley Ave Building 100, Suite 101 Orange Park, FL - 320734560 |
| Business Phone Number: | 9042784999 |
| Business Fax Number: | 9042788891 |
| Mailing Address: | 1703 Mossy Cypress Ln, JACKSONVILLE |
| State: | FL |
| Postal Code: | 322235023 |
| Phone Number: | 9044775678 |
| Fax Number: | |
| NPI Enumeration Date: | 01/17/2007 |
| NPI Last Update Date: | 02/29/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | SW0000953 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |