Provider Demographics
NPI:1962188730
Name:SPURR, JANNA COLLEEN (LCSW)
Entity type:Individual
Prefix:
First Name:JANNA
Middle Name:COLLEEN
Last Name:SPURR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 N. FIRST ST.
Mailing Address - Street 2:
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001
Mailing Address - Country:US
Mailing Address - Phone:704-983-4216
Mailing Address - Fax:704-983-6662
Practice Address - Street 1:960 N. FIRST STREET
Practice Address - Street 2:
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001
Practice Address - Country:US
Practice Address - Phone:704-983-4216
Practice Address - Fax:704-983-6662
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0117961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical