Basic Information
| Provider Information | |||||||||
| NPI: | 1437433851 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SPENCINER | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1 | ||||||||
| Address2: | |||||||||
| City: | CAYUTA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 148240001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6073396849 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 459 PHILO RD | ||||||||
| Address2: | |||||||||
| City: | ELMIRA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 149031051 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077952241 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2011 | ||||||||
| LastUpdateDate: | 10/04/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041S0200X | 7226283 | NY | Y | Behavioral Health & Social Service Providers | Social Worker | School |
No ID Information.