| Sparrow Therapeutic Services Llc | |
|
1515 Market St Ste 1200 Philadelphia PA 19102-1932 | |
| (215) 259-8078 | |
| (855) 564-1867 |
| Full Name | Sparrow Therapeutic Services Llc |
|---|---|
| Speciality | Counselor |
| Location | 1515 Market St Ste 1200, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Shameka Maria Sparrow (CLINICAL ADMINISTRATOR) |
| Authorized Official Contact | 2152598078 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sparrow Therapeutic Services Llc 1515 Market St Ste 1200 Philadelphia PA 19102-1932 Ph: (215) 259-8078 | Sparrow Therapeutic Services Llc 1515 Market St Ste 1200 Philadelphia PA 19102-1932 Ph: (215) 259-8078 |
| NPI Number | 1073230124 |
|---|---|
| Provider Enumeration Date | 10/19/2022 |
| Last Update Date | 10/19/2022 |
| Certification Date | 10/19/2022 |
| Medicare PECOS PAC ID | 9133592173 |
|---|---|
| Medicare Enrollment ID | O20230222002190 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073230124 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| Provider Name | Shameka Maria Sparrow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063700938 PECOS PAC ID: 7113286956 Enrollment ID: I20180124000688 |
| Provider Name | David Sparrow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083234538 PECOS PAC ID: 6901279066 Enrollment ID: I20230502001546 |
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