Latasha Judy Spencer, LLPC | |
11105 E Jefferson Ave, Detroit, MI 48214-3317 | |
(248) 417-1784 | |
Not Available |
Full Name | Latasha Judy Spencer |
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Gender | Female |
Speciality | Counselor |
Location | 11105 E Jefferson Ave, Detroit, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1003469644 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | 6401017425 (Michigan) | Primary |
Entity Name | Ascension Eastwood Behavioral Health |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1396787701 PECOS PAC ID: 2163324492 Enrollment ID: O20040126000572 |
Mailing Address | Practice Location Address |
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Latasha Judy Spencer, LLPC 11105 E Jefferson Ave, Detroit, MI 48214-3317 Ph: (248) 417-1784 | Latasha Judy Spencer, LLPC 11105 E Jefferson Ave, Detroit, MI 48214-3317 Ph: (248) 417-1784 |
Anthony Jerome Allen, AAS., CAC II Counselor Medicare: Not Enrolled in Medicare Practice Location: 12010 Linwood St, Detroit, MI 48206 Phone: 313-867-1090 Fax: 313-867-0706 | |
Mr. Brian R Cogliati, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1852 W Grand Blvd, 1852 W. Grand Blvd, Detroit, MI 48208 Phone: 313-894-8444 Fax: 313-894-5542 | |
Mr. Gregory Charles Guice, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 1151 Taylor Ave., Detroit, MI 48202 Phone: 313-874-8715 | |
Ms. Carol Potter, MA, BCBA, LBA Counselor Medicare: Not Enrolled in Medicare Practice Location: 2200 Hunt St, Detroit, MI 48207 Phone: 248-537-2516 | |
Mrs. Lisa Polk-woolfolk, MS, LLPC, CAC-M Counselor Medicare: Not Enrolled in Medicare Practice Location: 3731 Rivard St, Detroit, MI 48207 Phone: 313-258-9713 | |
Alicia Monique Lurry, LPC Counselor Medicare: Medicare Enrolled Practice Location: 8171 Parkland, Detroit, MI 48239 Phone: 313-282-7567 | |
Mr. Darren Kilgore, Counselor Medicare: Not Enrolled in Medicare Practice Location: 269 Walker St, 538, Detroit, MI 48207 Phone: 313-610-0134 |