Organization
SPARK CHANGE PATHWAYS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASSANDRA M SMITH (CEO)
(216) 716-0202
Entity
Organization
Contact information
Practice address
7055 ENGLE RD BLDG 6-601, MIDDLEBURG HEIGHTS, OH 44130-8491
(216) 260-3363
Mailing address
7055 ENGLE RD BLDG 6-601, MIDDLEBURG HEIGHTS, OH 44130-8491
(216) 260-3363
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
163W00000X
Registered Nurse
—
—
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
—
—
163WC0400X
Case Management Registered Nurse
—
—
171M00000X
Case Manager/Care Coordinator
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
385H00000X
Respite Care
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
Other
Enumeration date
03/25/2026
Last updated
03/25/2026
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