Provider Demographics
NPI:1801612478
Name:SPENCER, SIERRA MONTREAS (LPC)
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:MONTREAS
Last Name:SPENCER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 YEARDLEY DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-3234
Mailing Address - Country:US
Mailing Address - Phone:757-277-4071
Mailing Address - Fax:
Practice Address - Street 1:11835 FISHING POINT DR STE 202
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-2585
Practice Address - Country:US
Practice Address - Phone:757-243-1033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-28
Last Update Date:2024-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701014222101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health