Provider Demographics
NPI:1831123959
Name:SPENCER, JARROD TRON (PSYCHOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:JARROD
Middle Name:TRON
Last Name:SPENCER
Suffix:
Gender:M
Credentials:PSYCHOLOGIST
Other - Prefix:DR
Other - First Name:JARROD
Other - Middle Name:
Other - Last Name:SPENCER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSY D, LLC
Mailing Address - Street 1:3400 BATH PIKE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-2466
Mailing Address - Country:US
Mailing Address - Phone:610-867-7770
Mailing Address - Fax:610-867-7778
Practice Address - Street 1:3400 BATH PIKE
Practice Address - Street 2:SUITE 302
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-2466
Practice Address - Country:US
Practice Address - Phone:610-867-7770
Practice Address - Fax:610-867-7778
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015497103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASP1818916OtherHIGH MARK BS
PA50051767OtherCAPITAL BLUE CROSS
PASP1818916OtherHIGH MARK BS