Provider Demographics
NPI:1053409300
Name:SPENCE, DAVID C (LCMHC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:SPENCE
Suffix:
Gender:M
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 647
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05601-0647
Mailing Address - Country:US
Mailing Address - Phone:802-229-8000
Mailing Address - Fax:802-229-8030
Practice Address - Street 1:157 BARRE STREET
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602
Practice Address - Country:US
Practice Address - Phone:802-229-8000
Practice Address - Fax:802-229-8030
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068-0000100101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT2102757OtherCIGNA
VT989026COtherMVP HEALTHCARE
VT1007323Medicaid
VT00029999OtherBC/BS VT
VT360339OtherTRICARE