Provider Demographics
NPI:1760243174
Name:SPARKS, KARA CHRISTINE (LCSW, CCM)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:CHRISTINE
Last Name:SPARKS
Suffix:
Gender:F
Credentials:LCSW, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10300 HIAWATHA DR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-8311
Mailing Address - Country:US
Mailing Address - Phone:512-705-0731
Mailing Address - Fax:
Practice Address - Street 1:10300 HIAWATHA DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-8311
Practice Address - Country:US
Practice Address - Phone:512-705-0731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX587021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical