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General NPI Number Information
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NPI Number | 1225333149
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Entity Type | Individual
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Provider Name | PATRICIA SPENCER LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/25/2011
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Last Update Date | 03/23/2016
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Provider Practice Location Address
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Address Line | 46 CEDAR BROOK DR
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City | SOMERSET
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State | NJ
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Zip | 08873-2854
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Country | US
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Telephone | 732-672-3991
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5501
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City | SOMERSET
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State | NJ
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Zip | 08875-5501
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Country | US
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Telephone | 732-672-3991
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 445C05261200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05261200
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License Number State | NJ
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