MEDICARE: MRS. KARYN A SPENCER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor		FL

General Provider Information

NPI Number	:	1356285761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KARYN A SPENCER

Provider Business Mailing Address
First Line	:	6700 S FLORIDA AVE STE 33
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33813-3312
Country	:	US
Telephone Number	:	863-330-4097
Fax Number	:	863-337-4123

Provider Business Practice Location Address
First Line	:	6700 S FLORIDA AVE STE 33
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33813-3312
Country	:	US
Telephone Number	:	863-330-4097
Fax Number	:	863-337-4123

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2026
Last Update Date	:	04/16/2026

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