Provider Demographics
NPI:1992819932
Name:SPENCER, DORIS (LCSW)
Entity type:Individual
Prefix:MS
First Name:DORIS
Middle Name:
Last Name:SPENCER
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 1:4 LEFFLER HILL RD
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-2608
Mailing Address - Country:US
Mailing Address - Phone:908-806-8780
Mailing Address - Fax:908-806-8780
Practice Address - Street 1:4 LEFFLER HILL RD
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-2608
Practice Address - Country:US
Practice Address - Phone:908-806-8780
Practice Address - Fax:908-806-8780
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ44SC001400001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ44SC00140000Medicare UPIN
NJ637362Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER