Doctor Name: | MRS. CAROL SUE SPENCER |
NPI Number: | 1083786990 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW, ACSW |
License Number: | 34000454A |
Business Practice Address: | 315 S Berkley Rd Kokomo, IN - 469015114 |
Business Phone Number: | 7654579719 |
Business Fax Number: | 7654575991 |
Mailing Address: | 4015 Albright Rd, KOKOMO |
State: | IN |
Postal Code: | 469024469 |
Phone Number: | 7654551020 |
Fax Number: | 7654551920 |
NPI Enumeration Date: | 11/15/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 34000454A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |