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General NPI Number Information
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NPI Number | 1609602259
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Entity Type | Organization
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Legal Business Name | SPARKLE ON COUNSELING
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Dates
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Enumeration Date | 09/10/2024
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Last Update Date | 09/10/2024
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Provider Practice Location Address
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Address Line | 959 MERRIMON AVE STE 8B
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City | ASHEVILLE
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State | NC
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Zip | 28804-2353
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Country | US
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Telephone | 828-290-9579
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Fax |
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Provider Business Mailing Address
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Address Line | 16 COLUMBIA CIR
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City | HENDERSONVILLE
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State | NC
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Zip | 28792-7005
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Country | US
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Telephone | 828-290-3021
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AUTUMN RIEDEL
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Credential | LCMHCA
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Telephone | 828-290-3021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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