Provider Demographics
NPI:1972704518
Name:SPENCER, DUFFY (PHD, LMHC)
Entity Type:Individual
Prefix:DR
First Name:DUFFY
Middle Name:
Last Name:SPENCER
Suffix:
Gender:F
Credentials:PHD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 DARTMOUTH STREET
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-3420
Mailing Address - Country:US
Mailing Address - Phone:516-334-8985
Mailing Address - Fax:
Practice Address - Street 1:609 DARTMOUTH ST
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-3420
Practice Address - Country:US
Practice Address - Phone:516-334-8985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002938-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health