Healthcare Provider Details

I. General information

NPI: 1033248539
Provider Name (Legal Business Name): ELIZABETH ANNE SPENCER MS ED, LIMHP, LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 10/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

432 N MINNESOTA AVE
HASTINGS NE
68901-5254
US

IV. Provider business mailing address

432 N MINNESOTA AVE
HASTINGS NE
68901-5254
US

V. Phone/Fax

Practice location:
  • Phone: 402-463-1400
  • Fax: 402-463-1442
Mailing address:
  • Phone: 402-463-1400
  • Fax: 402-463-1442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number526
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number233
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: