Healthcare Provider Details

I. General information

NPI: 1225360290
Provider Name (Legal Business Name): VICTORIA LYNNETTE SMITH SPENCER MSW LCSW LCAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2010
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1831 N FAYETTEVILLE ST
ASHEBORO NC
27203-3273
US

IV. Provider business mailing address

200 E 2ND AVE
GASTONIA NC
28052-4358
US

V. Phone/Fax

Practice location:
  • Phone: 336-672-1300
  • Fax: 336-672-3044
Mailing address:
  • Phone: 704-874-1974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberP00900
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number15023
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC010237
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: