Provider Demographics
NPI:1255477014
Name:SPARKS, CATHY FORD (LPC LMFT)
Entity Type:Individual
Prefix:MISS
First Name:CATHY
Middle Name:FORD
Last Name:SPARKS
Suffix:
Gender:F
Credentials:LPC LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2439 SCOTT ST
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29302
Mailing Address - Country:US
Mailing Address - Phone:864-582-0073
Mailing Address - Fax:
Practice Address - Street 1:MIDDLE TYGER COMMUNITY CENTER
Practice Address - Street 2:84 GRACE RD
Practice Address - City:LYMAN
Practice Address - State:SC
Practice Address - Zip Code:29365
Practice Address - Country:US
Practice Address - Phone:864-439-7760
Practice Address - Fax:864-439-7034
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLPC2439101Y00000X
SCLMFT106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist