| Sparks Of Light Psychotherapy, Pllc | |
|
123 Harvard Ave Pueblo CO 81004-1223 | |
| (918) 658-8352 | |
| Not Available |
| Full Name | Sparks Of Light Psychotherapy, Pllc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 123 Harvard Ave, Pueblo, Colorado |
| Authorized Official Name and Position | Paitton Nicole Kendrick Callery (OWNER/SOLO PRACTITIONER) |
| Authorized Official Contact | 9186588352 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sparks Of Light Psychotherapy, Pllc 123 Harvard Ave Pueblo CO 81004-1223 Ph: (918) 658-8352 | Sparks Of Light Psychotherapy, Pllc 123 Harvard Ave Pueblo CO 81004-1223 Ph: (918) 658-8352 |
| NPI Number | 1477360600 |
|---|---|
| Provider Enumeration Date | 12/11/2024 |
| Last Update Date | 01/07/2025 |
| Certification Date | 01/07/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477360600 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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