Organization
SHERRY V. SPARKS, LCSW, LLC
Active
Other names
Sherry V. Sparks, LCSW
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRY V. SPARKS M.S.W., L.C.S.W. (LICENSED CLINICAL SOCIAL WORKER)
(601) 383-8089
Entity
Organization
Contact information
Practice address
840 E RIVER PL, SUITE 504, JACKSON, MS 39202-3493
(601) 383-8089
(601) 969-7160
Mailing address
840 E RIVER PL, SUITE 504, JACKSON, MS 39202-3493
(601) 383-8089
(601) 969-7160
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C7419
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
302G809006
MEDICARE GROUP PTAN
MS
Enumeration date
07/25/2006
Last updated
08/23/2010
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