Individual
CLAYTON SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMHC, LCAC
Contact information
Practice address
5470 E 16TH ST, INDIANAPOLIS, IN 46218-4861
(317) 621-5700
(317) 621-5991
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
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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