Provider Demographics
NPI:1396182283
Name:SPERBER, JUSTINE A (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JUSTINE
Middle Name:A
Last Name:SPERBER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3633 N 3RD AVE
Mailing Address - Street 2:UNIT #2011
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-3914
Mailing Address - Country:US
Mailing Address - Phone:919-583-3788
Mailing Address - Fax:
Practice Address - Street 1:3522 N 3RD AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-3903
Practice Address - Country:US
Practice Address - Phone:602-776-7676
Practice Address - Fax:602-776-3002
Is Sole Proprietor?:No
Enumeration Date:2013-05-31
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC009538101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health