Provider Demographics
NPI:1487090957
Name:STAPLES, SPENCER JOSEPH (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:SPENCER
Middle Name:JOSEPH
Last Name:STAPLES
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 NECTAR WAY
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:UT
Mailing Address - Zip Code:84045-6448
Mailing Address - Country:US
Mailing Address - Phone:801-915-4242
Mailing Address - Fax:
Practice Address - Street 1:3051 W MAPLE LOOP DR STE 300
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-6552
Practice Address - Country:US
Practice Address - Phone:385-336-4740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-10
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8556085-35011041C0700X
UT8556085-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical