Kathryn N Spencer, DNP, APRN, PMHNP-BC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

7851 Issued in CT

Practice address

300 Church St Ste 204
Wallingford, CT 06492-2253

Phone

(203) 314-0940

NPI assigned

Sep 14, 2018

Last updated

Sep 8, 2023By 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 2

Addresses

Other identifiers 1

Other names 1

• Teresa K Spencer Former name

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lswhb LLC

  dba ETHOS Care

  • Behavioral Neurology & Neuropsychiatry Physician
  • Milford, OH
  • NPI 1407325939

  CT

  Medicare reassignment NPD
• Inspire Recovery LLC

  • Mental Health Counselor
  • Wallingford, CT
  • NPI 1265934103

  Psychiatric/Mental Health

  NPD
• Prohealth Physicians PC

  • Family Medicine Physician
  • Farmington, CT
  • NPI 1720194053
  NPD (past)

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

{
    "created_epoch": "1536883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1578046611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CHURCH ST",
            "address_2": "STE 205",
            "city": "YALESVILLE",
            "state": "CT",
            "postal_code": "064922253",
            "telephone_number": "203-314-0940",
            "fax_number": "860-530-9567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CHURCH ST STE 204",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922253",
            "telephone_number": "203-314-0940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "KATHRYN",
        "middle_name": "N",
        "credential": "DNP, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-14",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "7851",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "7851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008083045",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "SPENCER",
            "middle_name": "K",
            "credential": "DNP, APRN, PMHNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Suellen Sonosky, MSW
• Erin Soprano, DPT
• Soul Friends, Inc
• Rebecca Lynn Spadory
• Specialized Education of Connecticut Inc.
• George Spivack, M.D.
• Emily Sprankel
• Joanna Maria Stachowicz, RN
• Harry B Stanley Jr., MS, BCBA, LBA
• Sharon B Starr, LCSW

• Psychiatry Physician in Wallingford, CT
• Providers in Wallingford, CT by specialty
• Psychiatry Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; 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.