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General NPI Number Information
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NPI Number | 1285356311
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Entity Type | Individual
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Provider Name | OLIVIA L SPENCE LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/15/2022
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 5215 N. CALIFORNIA AVE. SUITE F603
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City | CHICAGO
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State | IL
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Zip | 60625-8564
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Country | US
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Telephone | 773-878-3627
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Fax |
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Provider Business Mailing Address
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Address Line | 2650 RIDGE AVE # 1223
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City | EVANSTON
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State | IL
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Zip | 60201-1700
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Country | US
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Telephone | 847-570-2040
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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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 | 149027933
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License Number State | IL
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