Provider Demographics
NPI:1861911794
Name:SPIGENER, DANA MARTIN (LMHC)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:MARTIN
Last Name:SPIGENER
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:DJ
Other - Middle Name:
Other - Last Name:SPIGENER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5401 S KIRKMAN RD # 760
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7940
Mailing Address - Country:US
Mailing Address - Phone:321-332-6984
Mailing Address - Fax:
Practice Address - Street 1:5401 S KIRKMAN RD # 760
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7940
Practice Address - Country:US
Practice Address - Phone:321-332-6984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13751101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health