Provider Demographics
NPI:1639441546
Name:SPENCER, JOSETTE C (RN, LPC, LMSW)
Entity Type:Individual
Prefix:MS
First Name:JOSETTE
Middle Name:C
Last Name:SPENCER
Suffix:
Gender:F
Credentials:RN, LPC, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 DREXEL DR.
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78412
Mailing Address - Country:US
Mailing Address - Phone:361-299-5626
Mailing Address - Fax:361-299-5626
Practice Address - Street 1:821 DREXEL DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412
Practice Address - Country:US
Practice Address - Phone:361-299-5626
Practice Address - Fax:361-299-5626
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLPC#5475101Y00000X
TXLMSW#12027104100000X
TXR.N. # 235031163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health