Provider Demographics
NPI:1982016218
Name:SPAHR, MARY JANE (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:JANE
Last Name:SPAHR
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 N CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:PA
Mailing Address - Zip Code:17078-1106
Mailing Address - Country:US
Mailing Address - Phone:717-208-0774
Mailing Address - Fax:
Practice Address - Street 1:626 N CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:PA
Practice Address - Zip Code:17078-1106
Practice Address - Country:US
Practice Address - Phone:717-208-0774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-21
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW017852101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health