Spark Wellness | |
692b Ritchie Hwy Ste 101 Severna Park MD 21146-3938 | |
(410) 245-2199 | |
Not Available |
Full Name | Spark Wellness |
---|---|
Speciality | Counselor |
Location | 692b Ritchie Hwy Ste 101, Severna Park, Maryland |
Authorized Official Name and Position | Stephanie Hibbard (PARTNER) |
Authorized Official Contact | 4102452199 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Spark Wellness 102 Stauffer Rd Severna Park MD 21146-3021 Ph: (410) 245-2199 | Spark Wellness 692b Ritchie Hwy Ste 101 Severna Park MD 21146-3938 Ph: (410) 245-2199 |
NPI Number | 1366131559 |
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Provider Enumeration Date | 05/03/2023 |
Last Update Date | 05/03/2023 |
Certification Date | 05/03/2023 |
Medicare PECOS PAC ID | 1850745779 |
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Medicare Enrollment ID | O20230927000265 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366131559 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Provider Name | Stephanie Hibbard |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1982794319 PECOS PAC ID: 5092872382 Enrollment ID: I20090401000439 |
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