Spencer, Thomas J

Spencer, Thomas J is an individual health care provider with primary practice located at 2625 Fairway Dr Suite E, Fulton MO 65251-3936. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Forensic. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Spencer, Thomas J can be contacted via phone (573) 642-1775.

Contact Information

Primary practice address
2625 Fairway Dr Suite E Fulton MO 65251-3936
Phone: (573) 642-1775
Fax: (573) 642-1850
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 2003030098 Missouri
Behavioral Health & Social Service Providers / Clinical 103TC0700X 2003030098 Missouri
Behavioral Health & Social Service Providers / Forensic 103TF0200X 2003030098 Missouri

Profile Details

NPI number 1538211230
LBN Legal business name Spencer, Thomas J
Credentials PSY D
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 16th, 2007
Last updated Mar 28th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538211230 NPPES
Missouri MEDICAID 498312305

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