Provider Demographics
NPI:1619005162
Name:SPENCER COUNSELING SERVICES, INC.
Entity type:Organization
Organization Name:SPENCER COUNSELING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ERNESTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:704-451-8769
Mailing Address - Street 1:SPENCER COUNSELING SERVICES, INC.
Mailing Address - Street 2:P.O. BOX 43644
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-0042
Mailing Address - Country:US
Mailing Address - Phone:704-451-8769
Mailing Address - Fax:704-567-0189
Practice Address - Street 1:SPENCER COUNSELING SERVICES, INC.
Practice Address - Street 2:6500 ROCKSHIRE DR.
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-8059
Practice Address - Country:US
Practice Address - Phone:704-451-8769
Practice Address - Fax:704-567-0189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5042101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty