Provider Demographics
NPI:1295861326
Name:SPARKS, SHERRY V (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:V
Last Name:SPARKS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 COPPERFIELD DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-4147
Mailing Address - Country:US
Mailing Address - Phone:405-823-6020
Mailing Address - Fax:405-364-6403
Practice Address - Street 1:860 COPPERFIELD DR
Practice Address - Street 2:SUITE 3
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-4147
Practice Address - Country:US
Practice Address - Phone:405-823-6020
Practice Address - Fax:405-364-6403
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-25
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK50991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS302I809006OtherMEDICARE PTAN
GAR70998Medicare UPIN
GA80BBBVLMedicare PIN