Provider Demographics
NPI:1275815458
Name:SPARKS, NIKOLYA TRIONNE (LPC, LMFT, NCC)
Entity Type:Individual
Prefix:MS
First Name:NIKOLYA
Middle Name:TRIONNE
Last Name:SPARKS
Suffix:
Gender:F
Credentials:LPC, LMFT, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 872211
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70187-2211
Mailing Address - Country:US
Mailing Address - Phone:504-343-0427
Mailing Address - Fax:504-242-0840
Practice Address - Street 1:7001 BUNDY RD
Practice Address - Street 2:K20
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-2178
Practice Address - Country:US
Practice Address - Phone:504-343-0427
Practice Address - Fax:504-242-0840
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2739101YM0800X
LA764106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist