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General NPI Number Information
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NPI Number | 1376089185
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Entity Type | Organization
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Legal Business Name | SPENCER AND ASSOCIATES THERAPEUTIC ALLIANCE, PLLC
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Dates
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Enumeration Date | 01/18/2017
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Last Update Date | 12/02/2023
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Provider Practice Location Address
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Address Line | 12340 JONES RD STE 290
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City | HOUSTON
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State | TX
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Zip | 77070-3129
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Country | US
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Telephone | 832-756-2749
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Fax |
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Provider Business Mailing Address
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Address Line | 12822 IVYFOREST DR
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City | CYPRESS
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State | TX
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Zip | 77429-2013
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Country | US
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Telephone | 859-816-8226
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Fax | 859-201-1151
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Authorized Official
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Title or Position | OWNER
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Name | REGINA SPENCER
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Credential | LCSW
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Telephone | 832-756-2749
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4021
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License Number State | KY
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