Provider Demographics
NPI:1629785019
Name:SPAMER, MELISSA (LPCC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:SPAMER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2812 MOLINO DE VIENTO
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-6436
Mailing Address - Country:US
Mailing Address - Phone:505-913-1835
Mailing Address - Fax:505-230-2033
Practice Address - Street 1:826 CAMINO DE MONTE REY STE B3
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-3961
Practice Address - Country:US
Practice Address - Phone:505-913-1835
Practice Address - Fax:505-230-2033
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health