MEDICARE: THE SPARK CENTER FOR PLAY AND WELLNESS

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
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1184575144
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE SPARK CENTER FOR PLAY AND WELLNESS

Provider Business Mailing Address
First Line	:	PO BOX 1387
Second Line	:
City	:	FAIRBURN
State	:	GA
Zip	:	30213-8006
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	340 LAKE JONATHAN LN
Second Line	:
City	:	FAIRBURN
State	:	GA
Zip	:	30213-3911
Country	:	US
Telephone Number	:	404-550-4213
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TRANAE HARRIS-BINGHAM
Credential	:	PHD, LPC
Telephone Number	:	404-550-4213

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	02/05/2026

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Directions to “THE SPARK CENTER FOR PLAY AND WELLNESS ” Practice Location

Language	Start Address	Practice Location

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