Healthcare Provider Details

I. General information

NPI: 1285557595
Provider Name (Legal Business Name): ALECIA SARAH SPARKS CERTIFIED PEER SPECI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 W 232ND ST
BRONX NY
10463-3207
US

IV. Provider business mailing address

40 MORROW AVE APT 7TS
SCARSDALE NY
10583-8224
US

V. Phone/Fax

Practice location:
  • Phone: 718-884-2992
  • Fax:
Mailing address:
  • Phone: 347-302-9555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberNYCPS-P-33523
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: