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General NPI Number Information
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NPI Number | 1184575144
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Entity Type | Organization
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Legal Business Name | THE SPARK CENTER FOR PLAY AND WELLNESS
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Dates
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Enumeration Date | 02/05/2026
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 340 LAKE JONATHAN LN
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City | FAIRBURN
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State | GA
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Zip | 30213-3911
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Country | US
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Telephone | 404-550-4213
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1387
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City | FAIRBURN
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State | GA
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Zip | 30213-8006
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. TRANAE HARRIS-BINGHAM
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Credential | PHD, LPC
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Telephone | 404-550-4213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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