Healthcare Provider Details

I. General information

NPI: 1396662326
Provider Name (Legal Business Name): SPEAR EDUCATIONAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 ILDERTON ST
SUMMERVILLE SC
29483-8194
US

IV. Provider business mailing address

101 ILDERTON ST
SUMMERVILLE SC
29483-8194
US

V. Phone/Fax

Practice location:
  • Phone: 203-673-9887
  • Fax:
Mailing address:
  • Phone: 203-673-9887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MONALIZA GROSS MARTINEZ-LOUZADA
Title or Position: LICENSED PSYCHOEDUCATIONAL
Credential: LPES
Phone: 203-673-9887