Provider Demographics
NPI:1801012364
Name:SPEARING, PENNY SUE (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:PENNY
Middle Name:SUE
Last Name:SPEARING
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 CLOVER LN
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81006-2068
Mailing Address - Country:US
Mailing Address - Phone:719-553-8386
Mailing Address - Fax:
Practice Address - Street 1:940 CLOVER LN
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81006-2068
Practice Address - Country:US
Practice Address - Phone:719-553-8386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4189251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health