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General NPI Number Information
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NPI Number | 1588580898
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Entity Type | Organization
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Legal Business Name | INNER SPARK MENTAL HEALTH LLC
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Dates
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Enumeration Date | 06/29/2026
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Last Update Date | 06/29/2026
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Provider Practice Location Address
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Address Line | 26 WATCHTOWER DR
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City | ORMOND BEACH
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State | FL
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Zip | 32176-2886
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Country | US
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Telephone | 386-588-5668
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Fax | 386-200-4156
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Provider Business Mailing Address
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Address Line | 26 WATCHTOWER DR
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City | ORMOND BEACH
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State | FL
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Zip | 32176-2886
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Country | US
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Telephone | 386-588-5668
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Fax | 386-200-4156
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Authorized Official
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Title or Position | OWNER, CEO
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Name | CARLA HILL
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Credential | APRN, PMHNP-BC
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Telephone | 386-588-5668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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