Provider Demographics
NPI:1467214528
Name:WOOD, SPRING ROSE (LCMHCA)
Entity Type:Individual
Prefix:
First Name:SPRING
Middle Name:ROSE
Last Name:WOOD
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 CANTER FIELD LN
Mailing Address - Street 2:
Mailing Address - City:CANDLER
Mailing Address - State:NC
Mailing Address - Zip Code:28715-7134
Mailing Address - Country:US
Mailing Address - Phone:828-367-7298
Mailing Address - Fax:
Practice Address - Street 1:70 CANTER FIELD LN
Practice Address - Street 2:
Practice Address - City:CANDLER
Practice Address - State:NC
Practice Address - Zip Code:28715-7134
Practice Address - Country:US
Practice Address - Phone:828-367-7298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA19369101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health