Provider Demographics
NPI:1376760272
Name:SPARKES, BARRY HERD (EDD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:HERD
Last Name:SPARKES
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 SOUTHAMPTON RD
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-9506
Mailing Address - Country:US
Mailing Address - Phone:413-532-6835
Mailing Address - Fax:
Practice Address - Street 1:203 EAST ST
Practice Address - Street 2:
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-1234
Practice Address - Country:US
Practice Address - Phone:413-529-7805
Practice Address - Fax:413-529-7889
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6196103T00000X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling