Provider Demographics
NPI:1265711030
Name:SPENCE, JESSICA (LCSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:SPENCE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 N JAMES ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NEWPORT
Mailing Address - State:DE
Mailing Address - Zip Code:19804-3169
Mailing Address - Country:US
Mailing Address - Phone:302-633-0301
Mailing Address - Fax:302-633-0331
Practice Address - Street 1:190 SALEM CHURCH RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2938
Practice Address - Country:US
Practice Address - Phone:302-454-5421
Practice Address - Fax:302-368-1421
Is Sole Proprietor?:No
Enumeration Date:2011-08-11
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00010901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical