Provider Demographics
NPI:1962769356
Name:SPENCE, JESSICA LEA MOUNIER (LCMHCS)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:LEA MOUNIER
Last Name:SPENCE
Suffix:
Gender:F
Credentials:LCMHCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 N EUGENE ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1621
Mailing Address - Country:US
Mailing Address - Phone:336-496-2838
Mailing Address - Fax:
Practice Address - Street 1:713 N EUGENE ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1621
Practice Address - Country:US
Practice Address - Phone:336-496-2838
Practice Address - Fax:336-450-4464
Is Sole Proprietor?:No
Enumeration Date:2012-04-23
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA8487101Y00000X
NC8487101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor