Provider Demographics
NPI:1366565772
Name:SPINOSA, VICKI A (CMSW)
Entity type:Individual
Prefix:MS
First Name:VICKI
Middle Name:A
Last Name:SPINOSA
Suffix:
Gender:F
Credentials:CMSW
Other - Prefix:MRS
Other - First Name:VICKI
Other - Middle Name:A
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:42 NORMANDY CIR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38111-6136
Mailing Address - Country:US
Mailing Address - Phone:901-647-3091
Mailing Address - Fax:
Practice Address - Street 1:42 NORMANDY CIR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38111-6136
Practice Address - Country:US
Practice Address - Phone:901-647-3091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNCSW00000052881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical