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NPI Code Detail

MEDICARE: KRISTEN SPENCER LICSW

MEDICARE:   KRISTEN  SPENCER  LICSW
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
11041C0700XClinical Social WorkerISW02427RI

General Provider Information

NPI Number : 1689040263
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN SPENCER LICSW
Provider Business Mailing Address
First Line : 1992 OLD LOUISQUISSET PIKE
Second Line :
City : LINCOLN
State : RI
Zip : 02865-4590
Country : US
Telephone Number : 401-654-0656
Fax Number : 401-475-0729
Provider Business Practice Location Address
First Line : 1992 OLD LOUISQUISSET PIKE
Second Line :
City : LINCOLN
State : RI
Zip : 02865-4590
Country : US
Telephone Number : 401-475-0653
Fax Number : 401-475-0729
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2015
Last Update Date : 09/25/2019

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Directions to “ KRISTEN SPENCER LICSW” Practice Location

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