Provider Demographics
NPI:1164959730
Name:SPARKS, ARIANNA ELIZABETH (PHD, LMHP, PLP)
Entity Type:Individual
Prefix:
First Name:ARIANNA
Middle Name:ELIZABETH
Last Name:SPARKS
Suffix:
Gender:F
Credentials:PHD, LMHP, PLP
Other - Prefix:
Other - First Name:ARIANNA
Other - Middle Name:ELIZABETH
Other - Last Name:SPARKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1020 W 18TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-4707
Mailing Address - Country:US
Mailing Address - Phone:605-444-9700
Mailing Address - Fax:605-444-9701
Practice Address - Street 1:1020 W 18TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-4707
Practice Address - Country:US
Practice Address - Phone:605-444-9700
Practice Address - Fax:605-444-9701
Is Sole Proprietor?:No
Enumeration Date:2017-05-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11157101Y00000X
NE5186101Y00000X
NE583103T00000X
SD588103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor