Healthcare Provider Details

I. General information

NPI: 1891212395
Provider Name (Legal Business Name): SPALKA COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2017
Last Update Date: 08/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 E PRATER WAY STE 103
SPARKS NV
89434-8963
US

IV. Provider business mailing address

1091 CABOOSE CT
SPARKS NV
89434-5812
US

V. Phone/Fax

Practice location:
  • Phone: 775-331-1527
  • Fax: 775-331-1527
Mailing address:
  • Phone: 775-250-3971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. ROCH M SPALKA
Title or Position: OWNER
Credential: MFT
Phone: 775-250-3971