| Doctor Name: | SHANAN SPENCER |
| NPI Number: | 1760648836 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCPC |
| License Number: | LC2763 |
| Business Practice Address: | 150 Park Ave Frostburg, MD - 215322218 |
| Business Phone Number: | 3016895034 |
| Business Fax Number: | 3016895036 |
| Mailing Address: | 1180 Professional Ct, HAGERSTOWN |
| State: | MD |
| Postal Code: | 217405852 |
| Phone Number: | 3017913045 |
| Fax Number: | 2403133071 |
| NPI Enumeration Date: | 07/29/2008 |
| NPI Last Update Date: | 07/29/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LC2763 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |