Provider Demographics
NPI:1164128914
Name:SPARKS, SHARRON (LPC)
Entity Type:Individual
Prefix:
First Name:SHARRON
Middle Name:
Last Name:SPARKS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 BEAUFORT AVE
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-1703
Mailing Address - Country:US
Mailing Address - Phone:908-216-6659
Mailing Address - Fax:
Practice Address - Street 1:96 BEAUFORT AVE
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-1703
Practice Address - Country:US
Practice Address - Phone:908-216-6659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-03
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00242200101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health