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Individual
CLAYTON SPARKS
Active
Individual
CLAYTON SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMHC, LCAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
86000122A
IN
101YM0800X
Mental Health Counselor
Primary
39003190A
IN
Other
Enumeration date
01/05/2016
Last updated
11/30/2020
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