Mark L Paris, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810005324 Issued in VA

Practice address

12584 Darby Brook CT
Woodbridge, VA 22192-2485

Phone

(793) 431-3940

NPI assigned

Oct 13, 2005

Last updated

Aug 9, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  NPD (past)
• Diversified Counseling Services, LLC

  • Community/Behavioral Health Agency
  • Clinton, MD
  • NPI 1659744266
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1154319069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8028 OAK HOLLOW LN",
            "city": "FAIRFAX STATION",
            "state": "VA",
            "postal_code": "220392627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12584 DARBY BROOK CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922485",
            "telephone_number": "793-431-3940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARIS",
        "first_name": "MARK",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810005324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander John Papas, MD
• Paradise Healthcare LLC (Paradise Health Care)
• Paradox Mental Health
• Paramount Serenity Home Health Services, LLC
• Paris D Vaughn DDS PC (Pure Dental)
• Hyung Soon Park, MD
• Jineon Park
• Seojin Park
• Susan Park
• Yuka Park, PT

• Clinical Psychologist in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.