Provider Demographics
NPI:1194986067
Name:SPENCER PSYCHIATRIC & COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:SPENCER PSYCHIATRIC & COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSING PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:B
Authorized Official - Last Name:ECKHART
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:712-262-1808
Mailing Address - Street 1:PO BOX 680
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:IA
Mailing Address - Zip Code:51301-0680
Mailing Address - Country:US
Mailing Address - Phone:712-580-3882
Mailing Address - Fax:712-262-5532
Practice Address - Street 1:2016 HIGHWAY BLVD
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:IA
Practice Address - Zip Code:51301-2112
Practice Address - Country:US
Practice Address - Phone:712-580-3882
Practice Address - Fax:712-262-5532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-23
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Single Specialty