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NPI Code Detail

MEDICARE: CHERI LYNN SPARKS PH.D.

MEDICARE: CHERI LYNN SPARKS PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TB0200XCognitive & Behavioral PsychologistPY6844FL
2103TC1900XCounseling PsychologistPY6844FL
3103TF0200XForensic PsychologistPY6844FL
4103TP2701XGroup Psychotherapy PsychologistPY6844FL

General Provider Information

NPI Number : 1295936003
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHERI LYNN SPARKS PH.D.
Provider Business Mailing Address
First Line : 3341 TOMPKINS ST
Second Line :
City : PENSACOLA
State : FL
Zip : 32504-4431
Country : US
Telephone Number : 850-449-1821
Fax Number :
Provider Business Practice Location Address
First Line : 1150 N 12TH AVE
Second Line :
City : PENSACOLA
State : FL
Zip : 32501-3308
Country : US
Telephone Number : 850-449-1821
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2007
Last Update Date : 09/11/2025

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