Provider Demographics
NPI:1437433851
Name:SPENCINER, AMY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:
Last Name:SPENCINER
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:PO BOX 1
Mailing Address - Street 2:
Mailing Address - City:CAYUTA
Mailing Address - State:NY
Mailing Address - Zip Code:14824-0001
Mailing Address - Country:US
Mailing Address - Phone:607-339-6849
Mailing Address - Fax:
Practice Address - Street 1:459 PHILO RD
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14903-1051
Practice Address - Country:US
Practice Address - Phone:607-795-2241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY72262831041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool