| Sherry V. Sparks, Lcsw | |
|
840 E River Pl Suite 504 Jackson MS 39202-3493 | |
| (601) 383-8089 | |
| (601) 969-7160 |
| Full Name | Sherry V. Sparks, Lcsw |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 840 E River Pl, Jackson, Mississippi |
| Authorized Official Name and Position | Sherry V. Sparks (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 6013838089 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sherry V. Sparks, Lcsw 840 E River Pl Suite 504 Jackson MS 39202-3493 Ph: (601) 383-8089 | Sherry V. Sparks, Lcsw 840 E River Pl Suite 504 Jackson MS 39202-3493 Ph: (601) 383-8089 |
| NPI Number | 1528080561 |
|---|---|
| Provider Enumeration Date | 07/25/2006 |
| Last Update Date | 08/23/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528080561 | NPI | - | NPPES |
| 302G809006 | Other | MS | MEDICARE GROUP PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | C7419 (Mississippi) | Primary |
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