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General NPI Number Information
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NPI Number | 1538303771
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Entity Type | Individual
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Provider Name | SHERELL MARIE SPARKS M.S., CRC, LCPC
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Gender | Female
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Dates
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Enumeration Date | 04/30/2009
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 101 E DEYOUNG ST
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City | MARION
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State | IL
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Zip | 62959-3128
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Country | US
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Telephone | 618-693-9139
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Fax |
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Provider Business Mailing Address
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Address Line | 79 PARADISE LN
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City | METROPOLIS
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State | IL
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Zip | 62960-2413
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Country | US
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Telephone | 186-203-2799
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Fax | 186-524-2670
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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