Provider Demographics
NPI:1629092796
Name:SPARRELL, JAMES A (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:SPARRELL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:278 LAFAYETTE RD
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-5455
Mailing Address - Country:US
Mailing Address - Phone:403-436-0629
Mailing Address - Fax:603-431-8186
Practice Address - Street 1:278 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-5455
Practice Address - Country:US
Practice Address - Phone:403-436-0629
Practice Address - Fax:603-431-8186
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH577103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30004184Medicaid
NHRE1942Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER