JEANETTE EHLERS SPENCE (NPI# 1598076168) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598076168 |
| Entity Type | Individual |
| Full Name | JEANETTE EHLERS SPENCE |
| Credential | APRN, PMHCNS-BC |
| Practice Address |
115 Atrium Way Ste 221 Lake Psychological Services Columbia SC 29223-6383 |
| Practice Telephone | 8036998887 |
| Practice Fax Number | 8036998824 |
| Mailing Telephone | 8036998887 |
| Mailing Fax Number | 8036998824 |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2014-12-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SP0809X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Adult |
4184 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
115 ATRIUM WAY STE 221 LAKE PSYCHOLOGICAL SERVICES |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29223-6383 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013153170 | Virginia Galloway Cooper | Psychologist | 115 Atrium Way Ste 221, Columbia, SC 29223-6383 | 2008-12-19 |
| 1558823849 | Hannah Reckart | Psychologist | 115 Atrium Way Ste 221, Columbia, SC 29223-6383 | 2019-04-04 |
| 1801366174 | Leo John Draham | Psychologist | 115 Atrium Way Ste 221, Columbia, SC 29223-6383 | 2018-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619522794 | Timothy Drew Edwards | Dentist | 122 N. Brickyard Rd, Columbia, SC 29223 | 2019-08-06 |
| 1861983249 | Southern Pain Specialists | Physical Medicine & Rehabilitation | 115 Blarney Dr Ste 111, Columbia, SC 29223 | 2018-05-22 |
| 1710481452 | Evans Counseling and Consulting, LLC | Social Worker | 120 Wildewood Park Dr Ste A, Columbia, SC 29223 | 2018-03-19 |
| 1750824819 | Marquita Heyward | Counselor | 1 Winsor Cove Suite 303, Columbia, SC 29223 | 2016-11-22 |
| 1578015509 | Carolina Family Pharmacy, LLC | Pharmacy | 9153 Two Notch Road, Columbia, SC 29223 | 2016-10-25 |
| 1225485170 | Lisa Diaz | Occupational Therapy Assistant | 7601 Parlane Rd, Columbia, SC 29223 | 2016-05-20 |
| 1295199859 | Sarah Ann Riley | Nurse Practitioner | Cvs Pharmacy 121 Clemson Rd., Columbia, SC 29223 | 2016-04-11 |
| 1134583214 | Sara Alisha Pound | Behavioral Analyst | 97b Winterberry Ln, Columbia, SC 29223 | 2016-04-05 |
| 1508227653 | Lucy Elvira Vicioso-harris | Counselor | 1310 Oakcrest Dr Apt 318, Columbia, SC 29223 | 2016-03-17 |
| 1134585243 | Robin Heaton | Occupational Therapy Assistant | 7601 Parklane Road, Columbia, SC 29223 | 2016-01-05 |
| Find all providers in zip 29223 | ||||
| Taxonomy Code | 364SP0809X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Psych/Mental Health, Adult |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639106511 | Donna Willson Upchurch | Clinical Nurse Specialist | 1401 1/2 Calhoun St, Columbia, SC 29201-2509 | 2006-06-27 |
| 1477531812 | Jean Litzen Jerardi | Clinical Nurse Specialist | 10852 Green Mountain Circle, Columbia, MD 21044-2320 | 2006-01-05 |
| 1659394492 | Pharon A. Johnston | Clinical Nurse Specialist | 1330 Taylor At Marion Street, Palmetto Baptist Counseling Center, Columbia, SC 29201 | 2006-07-25 |
| 1114982626 | Rick Sharp | Clinical Nurse Specialist | 800 Hospital Dr, Columbia, MO 65201-5275 | 2006-04-18 |
| 1861457467 | Steven Koeppel | Clinical Nurse Specialist | 800 Hospital Dr, Columbia, MO 65201-5275 | 2006-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568905081 | Judy Claire Paull | Clinical Nurse Specialist | 18 Stable Gate Rd, Hilton Head Island, SC 29926-1059 | 2016-12-01 |
| 1457411910 | Diana L Bunzel | Clinical Nurse Specialist | 955 Legends Ter, Mt Pleasant, SC 29464-9527 | 2006-12-12 |
| 1063448108 | Marilyn Mcsherry Earle | Clinical Nurse Specialist | 10 Old Country Roses, Bluffton, SC 29909 | 2006-06-23 |
| 1154667202 | Laura Anita Dunn | Clinical Nurse Specialist | 452 Lakeshore Pkwy, Suite 105, Rock Hill, SC 29730-4291 | 2012-12-18 |
| 1487734620 | Mary L. Tobin | Clinical Nurse Specialist | 3025 Newcastle Loop, Myrtle Beach, SC 29588-4502 | 2006-10-16 |
| 1093810046 | Virginia A Rueger | Clinical Nurse Specialist | 171 Ashley Ave, Charleston, SC 29425-8908 | 2006-09-14 |
| 1861492092 | Susan Vigeant | Clinical Nurse Specialist | 2400 W Main St, Rock Hill, SC 29732-8968 | 2005-07-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.