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General NPI Number Information
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NPI Number | 1568686699
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Entity Type | Individual
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Provider Name | CHARMAINE D SPENCER LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 596 PROSPECT PL FL 3
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City | BROOKLYN
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State | NY
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Zip | 11238-4205
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Country | US
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Telephone | 718-362-1450
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Fax | 718-638-9124
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Provider Business Mailing Address
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Address Line | 330 LENOX RD APT 7S
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City | BROOKLYN
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State | NY
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Zip | 11226-2258
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Country | US
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Telephone | 718-287-2542
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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 | 074503-1
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License Number State | NY
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