Charles M Spellmann, PHD

Primary specialty

Forensic PsychologistTaxonomy code 103TF0200X

License

7515P Issued in AR

Practice address

790 Roberts Drive
Monticello, AR 71655

Phone

(870) 367-2461

Fax

(870) 367-1690

NPI assigned

May 28, 2008

Last updated

May 28, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Credentials

Doctor of Philosophy

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.

• Delta Counseling Associates Inc

  • Community/Behavioral Health Agency
  • Monticello, AR
  • NPI 1053364612
  NPD (past)

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211932800000",
    "number": "1902064868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10498 LOOMIS LANDING DR",
            "city": "DEVALLS BLUFF",
            "state": "AR",
            "postal_code": "72041",
            "telephone_number": "870-998-7206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 ROBERTS DRIVE",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "71655",
            "telephone_number": "870-367-2461",
            "fax_number": "870-367-1690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPELLMANN",
        "first_name": "CHARLES",
        "middle_name": "M",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-28",
        "last_updated": "2008-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "AR",
            "license": "7515P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southeast Clinic (Jefferson Management Services, Inc.d/b/a Southeast Clinic)
• Southeast Education Service Coop
• Southeast Emergency Medical Service, Inc
• Southern Roots Medical Essentials
• Specialty Eyecare of South Arkansas LLC
• Anita Mariette Spence, LPN
• Christopher Spencer
• Latasha Renee Spencer
• Sydney McKay Sprawls
• Wanda Stanley

• Forensic Psychologist in Monticello, AR
• Providers in Monticello, AR by specialty
• Forensic Psychologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; 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.