Provider Demographics
NPI:1598273948
Name:SPAUNHORST, BRIN N (LPC)
Entity Type:Individual
Prefix:
First Name:BRIN
Middle Name:N
Last Name:SPAUNHORST
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:BRIN
Other - Middle Name:N
Other - Last Name:BALLARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1412 E. ELM STREET
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65101
Mailing Address - Country:US
Mailing Address - Phone:660-221-0659
Mailing Address - Fax:
Practice Address - Street 1:1412 E. ELM STREET
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65101
Practice Address - Country:US
Practice Address - Phone:660-221-0659
Practice Address - Fax:866-654-3879
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-19
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional