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NPI Code Detail

MEDICARE: MS. SUSAN SPARKS LPC

MEDICARE: MS. SUSAN SPARKS LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor86834TX

General Provider Information

NPI Number : 1003641945
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUSAN SPARKS LPC
Provider Business Mailing Address
First Line : 1701 ROGERS RD APT 328
Second Line :
City : FORT WORTH
State : TX
Zip : 76107-6593
Country : US
Telephone Number : 817-422-3081
Fax Number :
Provider Business Practice Location Address
First Line : 3509 HULEN ST STE 107
Second Line :
City : FORT WORTH
State : TX
Zip : 76107-6834
Country : US
Telephone Number : 817-382-7130
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2024
Last Update Date : 11/03/2025

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Directions to “ MS. SUSAN SPARKS LPC” Practice Location

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