Provider Demographics
NPI:1851486021
Name:SPEAR, ALICE R (MSW)
Entity Type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:R
Last Name:SPEAR
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 ROUTE 28
Mailing Address - Street 2:MOUNTAINSIDE BUSINESS CENTER
Mailing Address - City:OSSIPEE
Mailing Address - State:NH
Mailing Address - Zip Code:03864
Mailing Address - Country:US
Mailing Address - Phone:603-539-3949
Mailing Address - Fax:603-539-5222
Practice Address - Street 1:127 ROUTE 28
Practice Address - Street 2:MOUNTAINSIDE BUSINESS CENTER
Practice Address - City:OSSIPEE
Practice Address - State:NH
Practice Address - Zip Code:03864
Practice Address - Country:US
Practice Address - Phone:603-539-3949
Practice Address - Fax:603-539-5222
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH80002372Medicaid
RE2372Medicare ID - Type Unspecified