Provider Demographics
NPI:1972974020
Name:SPENCER, BRIANA NICOLE
Entity Type:Individual
Prefix:MS
First Name:BRIANA
Middle Name:NICOLE
Last Name:SPENCER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 MYSTERY VIEW WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-1751
Mailing Address - Country:US
Mailing Address - Phone:702-713-4713
Mailing Address - Fax:702-757-2463
Practice Address - Street 1:622 MYSTERY VIEW WAY
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-1751
Practice Address - Country:US
Practice Address - Phone:702-713-4713
Practice Address - Fax:702-757-2463
Is Sole Proprietor?:No
Enumeration Date:2015-10-15
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No172V00000XOther Service ProvidersCommunity Health Worker