Individual provider Active NPI

John Hunter Spencer Jr., CSACA

  • Addiction (Substance Use Disorder) Counselor
  • Bristow, VA
National Provider Identifier
1407128044
Registry record updated Jan 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
0711000120 Issued in VA
Practice address
11835 Hazel Circle Dr
Bristow, VA 20136-2180
Phone
(703) 396-7326
NPI assigned
Jan 27, 2012
Last updated
Jan 27, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 0711000120 VA Primary

Addresses

Primary practice location

11835 Hazel Circle Dr
Bristow, VA 20136-2180

Mailing address

11835 Hazel Circle Dr
Bristow, VA 20136-2180
Phone (703) 396-7326

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0711000120VAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1327622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327622400000",
    "number": "1407128044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11835 HAZEL CIRCLE DR",
            "city": "BRISTOW",
            "state": "VA",
            "postal_code": "201362180",
            "telephone_number": "703-396-7326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11835 HAZEL CIRCLE DR",
            "city": "BRISTOW",
            "state": "VA",
            "postal_code": "201362180",
            "telephone_number": "703-396-7326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "JOHN",
        "middle_name": "HUNTER",
        "name_suffix": "Jr.",
        "credential": "CSACA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-27",
        "last_updated": "2012-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0711000120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristow, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2012; 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.