MEDICARE: ASHLEY T SPENCER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320800000X	Mental Illness Community Based Residential Treatment Facility		NC

General Provider Information

NPI Number	:	1518890151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY T SPENCER

Provider Business Mailing Address
First Line	:	3340 ROBINWOOD RD STE 100-499
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28054-6689
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2750 E WT HARRIS BLVD STE 120
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28213-0034
Country	:	US
Telephone Number	:	227-263-3435
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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Directions to “ ASHLEY T SPENCER ” Practice Location

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