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General NPI Number Information
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NPI Number | 1528080561
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Entity Type | Organization
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Legal Business Name | SHERRY V. SPARKS, LCSW, LLC
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 08/23/2010
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Provider Practice Location Address
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Address Line | 840 E RIVER PL SUITE 504
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City | JACKSON
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State | MS
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Zip | 39202-3493
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Country | US
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Telephone | 601-383-8089
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Fax | 601-969-7160
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Provider Business Mailing Address
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Address Line | 840 E RIVER PL SUITE 504
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City | JACKSON
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State | MS
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Zip | 39202-3493
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Country | US
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Telephone | 601-383-8089
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Fax | 601-969-7160
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | SHERRY V. SPARKS
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Credential | M.S.W., L.C.S.W.
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Telephone | 601-383-8089
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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 | C7419
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License Number State | MS
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