Provider Demographics
NPI:1043644081
Name:SPENCER, DONNA JOANN (LCSW)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:JOANN
Last Name:SPENCER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 HUEBNER RD
Mailing Address - Street 2:
Mailing Address - City:FORT RILEY
Mailing Address - State:KS
Mailing Address - Zip Code:66442-4030
Mailing Address - Country:US
Mailing Address - Phone:785-239-7000
Mailing Address - Fax:630-570-5779
Practice Address - Street 1:BUILDING 158
Practice Address - Street 2:ROSE BARRACKS
Practice Address - City:VILSECK
Practice Address - State:BAYERN
Practice Address - Zip Code:09112
Practice Address - Country:DE
Practice Address - Phone:785-410-5955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-27
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW154081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical