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General NPI Number Information
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NPI Number | 1760648836
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Entity Type | Individual
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Provider Name | SHANAN SPENCER LCPC
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Gender | Female
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Dates
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Enumeration Date | 07/29/2008
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 150 PARK AVE
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City | FROSTBURG
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State | MD
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Zip | 21532-2218
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Country | US
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Telephone | 301-689-5034
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Fax | 301-689-5036
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Provider Business Mailing Address
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Address Line | 1180 PROFESSIONAL CT
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City | HAGERSTOWN
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State | MD
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Zip | 21740-5852
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Country | US
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Telephone | 301-791-3045
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Fax | 240-313-3071
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 86645
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC2763
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 86645
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License Number State | TX
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