Provider Demographics
NPI:1770348666
Name:SPARKS, VALERIE A (LPC)
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:A
Last Name:SPARKS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3898 ESSEX HEIGHTS TRL
Mailing Address - Street 2:
Mailing Address - City:FORTSON
Mailing Address - State:GA
Mailing Address - Zip Code:31808-6975
Mailing Address - Country:US
Mailing Address - Phone:334-465-5749
Mailing Address - Fax:
Practice Address - Street 1:3898 ESSEX HEIGHTS TRL
Practice Address - Street 2:
Practice Address - City:FORTSON
Practice Address - State:GA
Practice Address - Zip Code:31808-6975
Practice Address - Country:US
Practice Address - Phone:334-465-5749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC014550101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty