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General NPI Number Information
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NPI Number | 1235900838
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Entity Type | Organization
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Legal Business Name | THERAPY SPARKS, LLC
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Dates
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Enumeration Date | 01/11/2024
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 1178 BROADWAY
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City | NEW YORK
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State | NY
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Zip | 10001-5404
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Country | US
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Telephone | 803-200-1895
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Fax |
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Provider Business Mailing Address
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Address Line | 300 CAUGHMAN FARM LN # LANE431
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City | LEXINGTON
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State | SC
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Zip | 29072-6864
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Country | US
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Telephone | 908-342-7236
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | JENNIFER SPARKS
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Credential | LCSW
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Telephone | 908-342-7236
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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