Provider Demographics
NPI:1124165444
Name:SPECTOR, JAMIE ANNE (MSW)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:ANNE
Last Name:SPECTOR
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 TOWNE AVE
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05667-9425
Mailing Address - Country:US
Mailing Address - Phone:510-846-8806
Mailing Address - Fax:
Practice Address - Street 1:174 ELM ST
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602-2262
Practice Address - Country:US
Practice Address - Phone:510-846-8806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089.00922661041C0700X
CA129921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical