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NPI 1457061822

NPI 1457061822 : ALEXUS SPENCER : WESTLAND, MI

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General NPI Number Information
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    NPI Number           |    1457061822
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    Entity Type          |    Individual 
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    Provider Name        |    ALEXUS SPENCER
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/28/2022
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    Last Update Date     |    12/12/2024
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Provider Practice Location Address
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    Address Line         |    34290 FORD RD 
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    City                 |    WESTLAND
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    State                |    MI
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    Zip                  |    48185-3051
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    Country              |    US
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    Telephone            |    248-525-7928
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    26541 GLENDALE 
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    City                 |    REDFORD
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    State                |    MI
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    Zip                  |    48239-2718
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    Country              |    US
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    Telephone            |    
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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        |    1041C0700X
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    Taxonomy Name        |    Clinical 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        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    6851116921
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    License Number State |    MI
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