Theresa Spencer LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

72387 Issued in TX

Legal business name

THERESA SPENCER LLC

Practice address

2008 NW Military Hwy Ste 4
San Antonio, TX 78213-2130

Phone

(210) 526-1757

Fax

(888) 213-8256

NPI assigned

Jan 9, 2017

Organization subpart

No

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

Authorized official

Name

Theresa Spencer, LPC, LCDC, LCPCNPI 1619344371

Title

Owner

Phone

(210) 526-1757

Specialties & licenses 3

Addresses

Other names 1

• Theresa Spencer LPC Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

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

• Theresa Spencer, LPC, LCDC, LCPC

  • Professional Counselor
  • San Antonio, TX
  • NPI 1619344371
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1483920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582329600000",
    "number": "1710423157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 BROADWAY ST",
            "address_2": "SUITE 104-117",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782093232",
            "telephone_number": "210-526-1757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2008 NW MILITARY HWY STE 4",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782132130",
            "telephone_number": "210-526-1757",
            "fax_number": "888-213-8256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERESA SPENCER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-09",
        "last_updated": "2020-02-22",
        "certification_date": "2020-02-22",
        "status": "A",
        "authorized_official_last_name": "SPENCER",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-526-1757",
        "authorized_official_credential": "LPC, LCDC, LCPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "TX",
            "license": "72387",
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "TX",
            "license": "72387",
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "TX",
            "license": "72387",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Theresa Spencer LPC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Therese Singson Miranda DDS PC
• Shawna Gaylen Theriot, LCSW
• Wendy Dawn Theriot, LPC
• Kathleen Nichole Thetford, RBT

• Adult Mental Health Clinic/Center in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Adult Mental Health Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.