Provider Demographics
NPI:1003839192
Name:DEARING, JUDY S (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JUDY
Middle Name:S
Last Name:DEARING
Suffix:
Gender:F
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 74
Mailing Address - Street 2:
Mailing Address - City:DANA
Mailing Address - State:NC
Mailing Address - Zip Code:28724-0074
Mailing Address - Country:US
Mailing Address - Phone:828-696-2222
Mailing Address - Fax:
Practice Address - Street 1:1303 5TH AVE W
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-4173
Practice Address - Country:US
Practice Address - Phone:828-696-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0043891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC133YJOtherBCBS PROVIDER ID
NC6002596Medicaid
NC133YJOtherBCBS PROVIDER ID