Bonnie Renee Spencer, LAPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

APC004001 Issued in GA

Practice address

104 Lakeshore Dr
Suite D
Saint Marys, GA 31558-3803

Phone

(912) 729-1120

Fax

(912) 729-1150

NPI assigned

Sep 24, 2013

Last updated

Sep 24, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Coastal Counseling Center, Inc.

  • Community/Behavioral Health Agency
  • Saint Marys, GA
  • NPI 1336318542
  NPD (past)

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

{
    "created_epoch": "1379980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379980800000",
    "number": "1316373178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 KRISTINS DR",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315581815",
            "telephone_number": "912-510-9294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 LAKESHORE DR",
            "address_2": "SUITE D",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315583803",
            "telephone_number": "912-729-1120",
            "fax_number": "912-729-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "BONNIE",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "LAPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-24",
        "last_updated": "2013-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "APC004001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Social Works LLC
• Southeast Chiropractic LLC
• Southeast Georgia Health System, Inc. (Southeast Georgia Health System - Camden Campus)
• Southeast Georgia Health System, Inc. (Senior Care Center - St. Marys)
• Southeast Georgia Radiology
• Richard L Spencer, DDS
• St. Marys Obstetrics & Gynecology, P. C. (St. Marys OB/GYN, P. C.)
• St. Marys Psychiatry, Inc.
• Cassey St.Rose, LPC
• Stanley M. Prince, DMD,PC

• Professional Counselor in Saint Marys, GA
• Providers in Saint Marys, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; 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.