LARRY ANTHONY SPENCE NPI 1013153253

NPI Information

NPI: 1013153253
Provider Name: LARRY ANTHONY SPENCE
Classification: Marriage & Family Therapist - 106H00000X
Entity Type: Individual
Address:
5626 N 91ST ST STE 301
MILWAUKEE, WI
ZIP 53225
Phone: (414) 461-1088
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Larry Anthony Spence is a marriage family therapist in Milwaukee, WI. The provider is a marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. Larry Anthony Spence NPI is 1013153253. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5626 N 91ST ST STE 301
MILWAUKEE, WI
ZIP 53225-745
Phone: (414) 461-1088
Fax: (414) 461-1049

The enumeration date for this NPI number is 12/17/2008 and was last updated on 12/17/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	4152-120	WISCONSIN	No
2	104100000X	Social Worker		4152-120	WISCONSIN	No
3	106H00000X	Marriage & Family Therapist				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	40921600	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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