Gwinn Alene Spence, LGCP, CAC-AD

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LGP15142 Issued in MD

Practice address

751 N Riverside Dr
Crownsville, MD 21032-1708

Phone

(443) 871-0698

NPI assigned

Dec 5, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1733356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1033925979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 N RIVERSIDE DR",
            "city": "CROWNSVILLE",
            "state": "MD",
            "postal_code": "210321708",
            "telephone_number": "443-871-0698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 N RIVERSIDE DR",
            "city": "CROWNSVILLE",
            "state": "MD",
            "postal_code": "210321708",
            "telephone_number": "443-871-0698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCE",
        "first_name": "GWINN",
        "middle_name": "ALENE",
        "credential": "LGCP, CAC-AD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-05",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "AC3321",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LGP15142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Crownsville, MD
• Providers in Crownsville, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.