Provider Demographics
NPI:1124880059
Name:SPENCER, CLAIRE MAXINE (APRN, PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:CLAIRE
Middle Name:MAXINE
Last Name:SPENCER
Suffix:
Gender:
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:843 MAIN ST STE 11
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-6041
Mailing Address - Country:US
Mailing Address - Phone:860-643-8870
Mailing Address - Fax:
Practice Address - Street 1:119C GRISWOLD ST STE 211
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-1099
Practice Address - Country:US
Practice Address - Phone:608-338-8256
Practice Address - Fax:860-310-1901
Is Sole Proprietor?:No
Enumeration Date:2024-01-25
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12824363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health