Healthcare Provider Details

I. General information

NPI: 1144189184
Provider Name (Legal Business Name): CHERIE CRAWFORD SPENCE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2026
Last Update Date: 01/16/2026
Certification Date: 01/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3922 ELECTRIC RD
ROANOKE VA
24018-4565
US

IV. Provider business mailing address

148 DRAKE TRL
CLOVERDALE VA
24077-3066
US

V. Phone/Fax

Practice location:
  • Phone: 540-556-4751
  • Fax:
Mailing address:
  • Phone: 540-556-4751
  • Fax: 540-556-4751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701015743
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: