Provider Demographics
NPI:1851955041
Name:SPENCER, KATHERINE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:
Last Name:SPENCER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 W CHESTER PIKE STE 108
Mailing Address - Street 2:
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-2629
Mailing Address - Country:US
Mailing Address - Phone:215-817-2386
Mailing Address - Fax:
Practice Address - Street 1:8600 W CHESTER PIKE STE 108
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-2629
Practice Address - Country:US
Practice Address - Phone:215-817-2386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-24
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0204431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical