Provider Demographics
NPI:1225360290
Name:SPENCER, VICTORIA LYNNETTE SMITH (MSW LCSW LCASA)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:LYNNETTE SMITH
Last Name:SPENCER
Suffix:
Gender:F
Credentials:MSW LCSW LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:485 OAK LEAF RD APT G
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27205
Mailing Address - Country:US
Mailing Address - Phone:919-724-8062
Mailing Address - Fax:
Practice Address - Street 1:1831 N FAYETTEVILLE ST
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-3273
Practice Address - Country:US
Practice Address - Phone:336-672-1300
Practice Address - Fax:336-672-3044
Is Sole Proprietor?:No
Enumeration Date:2010-02-02
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP00900101Y00000X
NC15023101YA0400X
NCC0102371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)