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NPI Code Detail

MEDICARE: MR. DWIGHT L SPERRY MA

MEDICARE: MR. DWIGHT L SPERRY MA
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
1101YM0800XMental Health Counselor79-16EAR
2101YM0800XMental Health Counselor11238TX
3101YP2500XProfessional Counselor1177TX

General Provider Information

NPI Number : 1396714721
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DWIGHT L SPERRY MA
Provider Business Mailing Address
First Line : 2904 ARKANSAS BLVD
Second Line :
City : TEXARKANA
State : AR
Zip : 71854-2536
Country : US
Telephone Number : 870-773-4655
Fax Number : 870-772-4650
Provider Business Practice Location Address
First Line : 2904 ARKANSAS BLVD
Second Line :
City : TEXARKANA
State : AR
Zip : 71854-2536
Country : US
Telephone Number : 870-773-4655
Fax Number : 870-772-4650
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2006
Last Update Date : 09/11/2025

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Directions to “ MR. DWIGHT L SPERRY MA” Practice Location

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