Jeanette Ehlers Spence, APRN, PMHCNS-BC

Primary specialty

Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X

License

4184 Issued in SC

Practice address

115 Atrium Way Ste 221
Lake Psychological Services
Columbia, SC 29223-6383

Phone

(803) 699-8887

Fax

(803) 699-8824

NPI assigned

Jun 29, 2010

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

Enrolled in SC

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 and National Provider Directory roles.

• Charleston Counseling Center PC

  • Mental Health Counselor
  • Mount Pleasant, SC
  • NPI 1316375678
  Medicare reassignment NPD
• Myrtle Beach Counseling Center

  • Mental Health Counselor
  • Myrtle Beach, SC
  • NPI 1235784661
  NPD
• Lake Psychological Services, LLC

  • Clinical Psychologist
  • Columbia, SC
  • NPI 1225061971
  NPD (past)

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

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1598076168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 ATRIUM WAY STE 221",
            "address_2": "LAKE PSYCHOLOGICAL SERVICES",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236383",
            "telephone_number": "803-699-8887",
            "fax_number": "803-699-8824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 ATRIUM WAY STE 221",
            "address_2": "LAKE PSYCHOLOGICAL SERVICES",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236383",
            "telephone_number": "803-699-8887",
            "fax_number": "803-699-8824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCE",
        "first_name": "JEANETTE",
        "middle_name": "EHLERS",
        "credential": "APRN, PMHCNS-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-29",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "SC",
            "license": "4184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Speech-Language Pathways Therapy Services, LLC
• Gloria Canty Speed, RN, BSN
• Otis Donnell Speight, MD
• Martha Kay Spell, MSP, CCC-SLP
• Taylor Leigh Spell, MA
• Casey Lynn Spencer, APRN
• Herbert Randolph Spencer, M.D.
• Jennifer K Spencer, APRN
• Orreshia Korynd Spencer, M.ED
• Jerodney Spicer, M.S.

• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Columbia, SC
• Providers in Columbia, SC by specialty
• Adult Psychiatric/Mental Health Clinical Nurse Specialist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; 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.