Jennifer Michael Spencer, PHD HSPP

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

20041405A Issued in IN

Practice address

631 N College Ave
Bloomington, IN 47404-3871

Phone

(812) 333-8474

NPI assigned

Aug 12, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jennifer Lynn Michael Former name

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jennifer Spencer PHD HSPP PC

  • Community/Behavioral Health Agency
  • Bloomington, IN
  • NPI 1932331345
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003828880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4956 N MUIRFIELD DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474041384",
            "telephone_number": "812-333-8474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 N COLLEGE AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474043871",
            "telephone_number": "812-333-8474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "JENNIFER",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PHD HSPP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "IN",
            "license": "20041405A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200298330",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MICHAEL",
            "middle_name": "LYNN",
            "credential": "PHD HSPP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John Kingsley Sparzo, MD
• Speech and Language Essentials, LLC
• Quentin L. Speight, M.A.
• Emily Spellman
• William Craig Spence, MD
• Katherine Spencer, DPT
• Sarah Spencer
• Thomas Spevak, PT
• Savanna Spice
• Lauren Spicer, RN

• Counseling Psychologist in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Counseling Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.