Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jared S Spencer

Individual provider Clinical Psychologist · NPI 1477199636

Dr. Jared S Spencer is a Clinical Psychologist in Prior Lake, Minnesota. Qualified in 2018, 8 years ago. Practices with Lorenz Clinic LLC, a 24-clinician group and accepts Medicare assignment. Licensed in Illinois and Minnesota.

Years since qualifying
8
Licensed in
IL, MN
In the registry since
2019
Specialties on file
2

Practice location Address checks out

16180 Hastings Ave SE Ste 205
Prior Lake, MN 55372-9228
Phone: (952) 443-4600
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence LP6688 (MN)
Clinical Psychologist Taxonomy 103TC0700X · Licence 071.010179 (IL)

Record details

NPI number1477199636
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 22, 2019
Last updated in NPPESJuly 7, 2021
Certification dateJuly 7, 2021
Mailing addressPo Box 51, Victoria, MN 55386-0051

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Lorenz Clinic Llc — 24 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Prior Lake