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Individual
THERESA SPENCER
Active
Individual
THERESA SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LCDC, LCPC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
32475
TX
101YM0800X
Mental Health Counselor
72387
TX
101YM0800X
Mental Health Counselor
LGP5607
MD
101YP2500X
Professional Counselor
Primary
72387
TX
101YP2500X
Professional Counselor
LGP5607
MD
Other
Enumeration date
08/28/2015
Last updated
02/22/2020
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