SPENCER T WARDLOW (NPI# 1912442138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912442138 |
| Entity Type | Individual |
| Full Name | SPENCER T WARDLOW |
| Credential | MSED |
| Practice Address |
804 N College Ave Ste 100 Bloomington IN 47404-3599 |
| Practice Telephone | 8128030663 |
| Practice Fax Number | 8122138390 |
| Mailing Telephone | 8128030663 |
| Mailing Fax Number | 8122138390 |
| Enumeration Date | 2016-12-23 |
| Last Update Date | 2017-12-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
804 N COLLEGE AVE STE 100 |
| City | BLOOMINGTON |
| State | IN |
| Zip Code | 47404-3599 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255971008 | Audrey E Moore | Counselor | 804 N College Ave Ste 100, Bloomington, IN 47404-3599 | 2020-01-09 |
| 1023572872 | Crystal Gail Ridlon | Counselor | 804 N College Ave Ste 100, Bloomington, IN 47404-3599 | 2019-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013526631 | Sandra Clark | Counselor | 205 N College Avenue, Suite 210a, Bloomington, IN 47404 | 2020-07-29 |
| 1750926085 | Michelle Christine Dustin | Nurse Practitioner | 610 N Morton Street, Bloomigton, IN 47404 | 2019-11-11 |
| 1316440191 | Julie D'argent | Psychologist | 205 N College Ave Ste 430, Bloomington, IN 47404 | 2018-03-17 |
| 1770966467 | Richard Lawson | Counselor | 1117 North Jackson Street, Bloomington, IN 47404 | 2015-06-30 |
| 1477952109 | Teresa R. Foster | Social Worker | 205 N. College Avenue, Suite 210b, Bloomington, IN 47404 | 2014-08-19 |
| 1073879532 | First Health Plus, Inc | Clinic/Center | 104 North Curry Pike, Bloomington, IN 47404 | 2012-04-09 |
| 1497079982 | Tera Dee Nance | Counselor | 101 W. Kirkwood Avenue, Suite 009 Fountain Square Mall, Bloomington, IN 47404 | 2010-03-26 |
| 1962643114 | Pathways Counseling Center | Community/Behavioral Health | 3866 W. Third Street, Bloomington, IN 47404 | 2009-03-18 |
| 1932358595 | Catherine Elizabeth Batka | Psychologist | 101 W. Kirkwood Ave, Suite 103, Bloomington, IN 47404 | 2008-09-18 |
| 1396901005 | Kijin Woo | Dentist | 330 N Jacob Drive, Bloomington, IN 47404 | 2008-08-01 |
| Find all providers in zip 47404 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013526631 | Sandra Clark | Counselor | 205 N College Avenue, Suite 210a, Bloomington, IN 47404 | 2020-07-29 |
| 1881218642 | Amy Lynn Hootman | Counselor | 2806 W Fawkesway Dr, Bloomington, IN 47404-1211 | 2020-06-07 |
| 1568096543 | Elm Services LLC | Counselor | 4076 N Brookwood Dr, Bloomington, IN 47404-9602 | 2020-02-27 |
| 1033759014 | Joseph Gerbofsky | Counselor | 410 S Landmark Ave, Bloomington, IN 47403-5000 | 2020-01-08 |
| 1508416371 | Amy Michelle Owens | Counselor | 400 W 7th St Ste 105g, Bloomington, IN 47404-3900 | 2019-09-13 |
| 1407401714 | Nichole M Day | Counselor | 101 W Kirkwood Ave Ste 210, Bloomington, IN 47404-6133 | 2019-08-04 |
| 1548721574 | Ashley Hilkey | Counselor | 4500 W Woodland Dr, Bloomington, IN 47404-9582 | 2019-03-31 |
| 1235695867 | Sandra K. Tucker, Ms, Lmhc, LLC | Counselor | 822 W 1st St Ste 4, Bloomington, IN 47403-2382 | 2019-02-19 |
| 1487120903 | Rebecca Anne Romberger | Counselor | 530 W Center, Bloomington, IL 61701-6170 | 2018-10-23 |
| 1740789635 | Jonna Marie Capio Lmhc LLC | Counselor | 3925 E Hagan St Ste 307, Bloomington, IN 47401-8649 | 2018-02-06 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 47404 |
Please comment or provide details below to improve the information on SPENCER T WARDLOW.
| 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.