Provider Demographics
NPI:1306311485
Name:SPEARS, SHONATHON R (MSW)
Entity type:Individual
Prefix:
First Name:SHONATHON
Middle Name:R
Last Name:SPEARS
Suffix:
Gender:M
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:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-5074
Mailing Address - Country:US
Mailing Address - Phone:606-393-5586
Mailing Address - Fax:606-928-5547
Practice Address - Street 1:5900 US ROUTE 60 STE B
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41102-9508
Practice Address - Country:US
Practice Address - Phone:606-393-5586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical