Provider Demographics
NPI:1932395316
Name:SPENCER PROFESSIONAL COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:SPENCER PROFESSIONAL COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, LPC, NCC
Authorized Official - Phone:814-262-7020
Mailing Address - Street 1:212 COLLEGE PARK PLZ
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904-2833
Mailing Address - Country:US
Mailing Address - Phone:814-262-7020
Mailing Address - Fax:813-262-7024
Practice Address - Street 1:212 COLLEGE PARK PLZ
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-2833
Practice Address - Country:US
Practice Address - Phone:814-262-7020
Practice Address - Fax:813-262-7024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003406101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty