Healthcare Provider Details

I. General information

NPI: 1568614972
Provider Name (Legal Business Name): JENNIFER ANNE SPINNER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2008
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 STIRLING ROAD STE. #6
COOPER CITY FL
33024
US

IV. Provider business mailing address

18434 NW 20TH ST
PEMBROKE PINES FL
33029-3802
US

V. Phone/Fax

Practice location:
  • Phone: 954-436-8326
  • Fax: 954-433-0603
Mailing address:
  • Phone: 305-409-0099
  • Fax: 954-744-4576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberSW4630
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberSW4630
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberSW4630
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberSW4630
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: