Provider Demographics
NPI:1558800631
Name:SPENCE, LYN (MA, LLPC)
Entity Type:Individual
Prefix:
First Name:LYN
Middle Name:
Last Name:SPENCE
Suffix:
Gender:F
Credentials:MA, LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:44070 W 12 MILE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-2648
Mailing Address - Country:US
Mailing Address - Phone:248-773-8440
Mailing Address - Fax:248-773-8441
Practice Address - Street 1:44070 W 12 MILE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-2648
Practice Address - Country:US
Practice Address - Phone:248-773-8440
Practice Address - Fax:248-773-8441
Is Sole Proprietor?:No
Enumeration Date:2017-02-22
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI6401015233101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional