Provider Demographics
NPI:1982339511
Name:SPENCER, CHYNA JEWELL (LCSWA)
Entity Type:Individual
Prefix:
First Name:CHYNA
Middle Name:JEWELL
Last Name:SPENCER
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1373
Mailing Address - Street 2:
Mailing Address - City:HAMLET
Mailing Address - State:NC
Mailing Address - Zip Code:28345-1373
Mailing Address - Country:US
Mailing Address - Phone:910-434-9693
Mailing Address - Fax:
Practice Address - Street 1:103 PINEY POINTE DR APT 214
Practice Address - Street 2:
Practice Address - City:HAMLET
Practice Address - State:NC
Practice Address - Zip Code:28345-2763
Practice Address - Country:US
Practice Address - Phone:910-434-9693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0178101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical