MEDICARE: SPENCER MAYS

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

General Provider Information

NPI Number	:	1720823388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SPENCER MAYS

Provider Business Mailing Address
First Line	:	1 E ERIE ST STE 525-2216
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-2740
Country	:	US
Telephone Number	:	858-987-6427
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 E ERIE ST STE 525-2216
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-2740
Country	:	US
Telephone Number	:	858-987-6427
Fax Number	:

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

Provider Enumeration Date	:	06/26/2024
Last Update Date	:	06/26/2024

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Directions to “ SPENCER MAYS ” Practice Location

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