Spectra Support Services, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SPECTRA SUPPORT SERVICES, LLC

Practice address

390 Reed Rd FL 1
Broomall, PA 19008-4008

Phone

(484) 450-6476

Fax

(484) 450-6476

NPI assigned

Jun 20, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Maleita Marguerite Olson, LCSWNPI 1427324177

Title

Director/ Co-Owner

Phone

(484) 450-6476

Specialties & licenses 9

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Maleita Marguerite Olson, LCSW

  • Clinical Social Worker
  • Broomall, PA
  • NPI 1427324177
  Medicare reassignment Care Compare group Authorized official
• Ashley Nicole Begley

  • Clinical Social Worker
  • Broomall, PA
  • NPI 1609496942
  Medicare reassignment Care Compare group NPD
• Patricia Jane Gonzalez, LPC, MT-BC

  • Mental Health Counselor
  • Broomall, PA
  • NPI 1396085387
  Medicare reassignment Care Compare group NPD
• Christine Marie Nelson, LSW

  • Clinical Social Worker
  • Broomall, PA
  • NPI 1649815960
  Medicare reassignment Care Compare group NPD
• Karen Weiss, LSW

  • Clinical Social Worker
  • Broomall, PA
  • NPI 1861042566
  Medicare reassignment Care Compare group NPD
• Rebecca Marie Zimmerman, LPC, MT-BC

  • Mental Health Counselor
  • Broomall, PA
  • NPI 1881268605
  Medicare reassignment NPD
• Yolanda Ann Cucinotta

  • Marriage & Family Therapist
  • Broomall, PA
  • NPI 1629606546
  NPD
• Alli Domers, MSW

  • Clinical Social Worker
  • Broomall, PA
  • NPI 1861861940

  Behavior Analyst

  NPD
• Raquel Emdur, LPC

  • Psychologist
  • Ardmore, PA
  • NPI 1205223138

  Professional

  NPD
• Sabrina Kirk, LPC

  • Professional Counselor
  • Havertown, PA
  • NPI 1114457280
  NPD
• Jillian Elisha Love

  • Professional Counselor
  • Broomall, PA
  • NPI 1396373221
  NPD
• Justin Ritchie Macdonald, LPC

  • Professional Counselor
  • Broomall, PA
  • NPI 1932855491

  Mental Health

  NPD

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585785600000",
    "number": "1134482409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 REED RD FL 1",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190084008",
            "telephone_number": "484-450-6476",
            "fax_number": "484-224-3398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 REED RD FL 1",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190084008",
            "telephone_number": "484-450-6476",
            "fax_number": "484-450-6476"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "724 W Rolling Rd",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "PA",
            "postal_code": "190641121",
            "country_code": "US",
            "telephone_number": "484-450-6476 x700",
            "fax_number": "484-224-3398",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "475 Lawrence Rd",
            "address_purpose": "LOCATION",
            "city": "Broomall",
            "state": "PA",
            "postal_code": "190083747",
            "country_code": "US",
            "telephone_number": "484-450-6476 x700",
            "fax_number": "610-544-7142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPECTRA SUPPORT SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-20",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "MALEITA",
        "authorized_official_middle_name": "MARGUERITE",
        "authorized_official_title_or_position": "DIRECTOR/ CO-OWNER",
        "authorized_official_telephone_number": "484-450-6476",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "PA",
            "license": "BH000073",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Music Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027817150022",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027817150023",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027817150024",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027817150019",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027817150021",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027817150020",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Jean Soeder, LPC
• Lauren Solometo
• Jennifer Soltys-Meletti, CRNP
• Linda Rose Spadaro
• Janet Sue Specter, M.D.
• Kyra Spencer, OTR/L
• Robert J Spennato, DMD
• Joseph Spina II, M.D.
• John D Sprandio, M.D.
• John D. Sprandio Jr., MD

• Clinical Social Worker in Broomall, PA
• Providers in Broomall, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.