Provider Demographics
NPI:1457160764
Name:SPENCER, TANNA MAY
Entity type:Individual
Prefix:
First Name:TANNA
Middle Name:MAY
Last Name:SPENCER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TANNA
Other - Middle Name:MAY
Other - Last Name:EGGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 486
Mailing Address - Street 2:
Mailing Address - City:SUTTON
Mailing Address - State:NE
Mailing Address - Zip Code:68979-0486
Mailing Address - Country:US
Mailing Address - Phone:402-773-0115
Mailing Address - Fax:402-773-0119
Practice Address - Street 1:301 S WAY AVE
Practice Address - Street 2:
Practice Address - City:SUTTON
Practice Address - State:NE
Practice Address - Zip Code:68979-2134
Practice Address - Country:US
Practice Address - Phone:402-773-0115
Practice Address - Fax:402-773-0119
Is Sole Proprietor?:No
Enumeration Date:2025-01-01
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1626101YA0400X
NE81571041C0700X
NE14270101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical