Provider Demographics
NPI:1457562100
Name:SPENCER, CAROL B (LMHC)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:B
Last Name:SPENCER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:534 UNION ST
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-3546
Mailing Address - Country:US
Mailing Address - Phone:508-965-1133
Mailing Address - Fax:
Practice Address - Street 1:285 OLD WESTPORT RD
Practice Address - Street 2:
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-2356
Practice Address - Country:US
Practice Address - Phone:508-999-8000
Practice Address - Fax:508-999-9257
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4357101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health