Organization
VITAL SPARK THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB MEANS LPC (OWNER/THERAPIST)
(913) 210-0732
Entity
Organization
Contact information
Practice address
734 ILLINOIS ST, LAWRENCE, KS 66044-2326
(913) 210-0732
Mailing address
734 ILLINOIS ST, LAWRENCE, KS 66044-2326
(913) 210-0732
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/29/2025
Last updated
04/24/2025
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