MEDICARE: KRISTEN SPEAR LPC

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	101YM0800X	Mental Health Counselor
2	101YP2500X	Professional Counselor	PC009362	PA

General Provider Information

NPI Number	:	1598026825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN SPEAR LPC

Provider Business Mailing Address
First Line	:	119 S DELAWARE AVE APT 8B3
Second Line	:
City	:	YARDLEY
State	:	PA
Zip	:	19067-1747
Country	:	US
Telephone Number	:	267-391-8137
Fax Number	:

Provider Business Practice Location Address
First Line	:	33 S DELAWARE AVE STE 202D
Second Line	:
City	:	YARDLEY
State	:	PA
Zip	:	19067-1524
Country	:	US
Telephone Number	:	267-391-8137
Fax Number	:

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

Provider Enumeration Date	:	06/04/2012
Last Update Date	:	11/30/2023

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