Provider Demographics
NPI:1164475927
Name:SPENCER, LINDA S (LPC)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:S
Last Name:SPENCER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1075
Mailing Address - Street 2:
Mailing Address - City:SALUDA
Mailing Address - State:NC
Mailing Address - Zip Code:28773-1075
Mailing Address - Country:US
Mailing Address - Phone:828-699-1009
Mailing Address - Fax:828-696-1538
Practice Address - Street 1:30 BEARCAT BLVD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-3622
Practice Address - Country:US
Practice Address - Phone:828-699-1009
Practice Address - Fax:828-696-1538
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NC3093101YP2500X
NC3064101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103138Medicaid