Healthcare Provider Details

I. General information

NPI: 1073230124
Provider Name (Legal Business Name): SPARROW THERAPEUTIC SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2022
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 REEDSDALE ST STE 403
PITTSBURGH PA
15233-2306
US

IV. Provider business mailing address

1515 MARKET ST STE 1200
PHILADELPHIA PA
19102-1932
US

V. Phone/Fax

Practice location:
  • Phone: 412-363-1702
  • Fax:
Mailing address:
  • Phone: 215-259-8078
  • Fax: 855-564-1867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SHAMEKA MARIA SPARROW
Title or Position: CLINICAL ADMINISTRATOR
Credential: LCSW
Phone: 215-259-8078