Provider Demographics
NPI:1841393006
Name:SPARKS, ANDREW R (LCSW)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:R
Last Name:SPARKS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1629 TREASURE HILLS BLVD
Mailing Address - Street 2:SUITE B-5
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8907
Mailing Address - Country:US
Mailing Address - Phone:956-366-4500
Mailing Address - Fax:956-366-4501
Practice Address - Street 1:1629 TREASURE HILLS BLVD
Practice Address - Street 2:SUITE B-5
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8907
Practice Address - Country:US
Practice Address - Phone:956-366-4500
Practice Address - Fax:956-366-4501
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX061841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX06184OtherLCSW