MEDICARE: SPARROW CENTER, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	171M00000X	Case Manager/Care Coordinator
2	101Y00000X	Counselor
3	101YA0400X	Addiction (Substance Use Disorder) Counselor
4	101YM0800X	Mental Health Counselor
5	104100000X	Social Worker
6	106H00000X	Marriage & Family Therapist
7	251S00000X	Community/Behavioral Health Agency
8	1041C0700X	Clinical Social Worker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366023434
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPARROW CENTER, LLC

Provider Business Mailing Address
First Line	:	2402 DAWSON RD STE 6
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31707-2380
Country	:	US
Telephone Number	:	229-999-6804
Fax Number	:	229-466-2661

Provider Business Practice Location Address
First Line	:	2402 DAWSON RD STE 6
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31707-2380
Country	:	US
Telephone Number	:	229-999-6804
Fax Number	:	229-466-2661

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	ASHLEY NICOLE HALL
Credential	:	LCSW
Telephone Number	:	229-999-6804

Provider Enumeration Date	:	04/19/2021
Last Update Date	:	08/19/2025

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Directions to “SPARROW CENTER, LLC ” Practice Location

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