Provider Demographics
NPI:1659344711
Name:SPIER, H FREDRIK (LCSW LMFT)
Entity Type:Individual
Prefix:
First Name:H
Middle Name:FREDRIK
Last Name:SPIER
Suffix:
Gender:M
Credentials:LCSW LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 FAIRGROUNDS RD
Mailing Address - Street 2:
Mailing Address - City:TIPTON
Mailing Address - State:IN
Mailing Address - Zip Code:46072-9596
Mailing Address - Country:US
Mailing Address - Phone:765-675-5961
Mailing Address - Fax:765-675-3777
Practice Address - Street 1:404 FAIRGROUNDS RD
Practice Address - Street 2:
Practice Address - City:TIPTON
Practice Address - State:IN
Practice Address - Zip Code:46072-9596
Practice Address - Country:US
Practice Address - Phone:765-675-5961
Practice Address - Fax:765-675-3777
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34002453A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN150840BMedicare ID - Type Unspecified