Provider Demographics
NPI:1922520998
Name:SPAGENSKI, ERIC JOHN (LGSW, LADC-CS)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:JOHN
Last Name:SPAGENSKI
Suffix:
Gender:M
Credentials:LGSW, LADC-CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3117 11 1/2 AVE NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-1474
Mailing Address - Country:US
Mailing Address - Phone:507-244-1303
Mailing Address - Fax:
Practice Address - Street 1:1027 7TH ST NW STE 2017
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-2666
Practice Address - Country:US
Practice Address - Phone:507-722-2342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-12
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health