Provider Demographics
NPI:1932464781
Name:SPENCER, ANNA ELISABETH (LICSW)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:ELISABETH
Last Name:SPENCER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 ASYLUM ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-2203
Mailing Address - Country:US
Mailing Address - Phone:339-200-9211
Mailing Address - Fax:
Practice Address - Street 1:10 ASYLUM ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-2203
Practice Address - Country:US
Practice Address - Phone:339-200-9211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-09
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1202221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical