Individual
MARK KEARNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
170 MORTON ST, JAMAICA PLAIN, MA 02130-3735
(617) 971-3369
Mailing address
58 SPALLUS RD, STOUGHTON, MA 02072-2749
(603) 498-5796
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
MA
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
12/05/2018
Last updated
12/05/2018
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