Provider Demographics
NPI:1538764915
Name:WILLIAMS, SPARKLE KANINA (LMSW)
Entity type:Individual
Prefix:MRS
First Name:SPARKLE
Middle Name:KANINA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3520 SIMMERING SUN CT
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89081-4050
Mailing Address - Country:US
Mailing Address - Phone:702-910-8525
Mailing Address - Fax:
Practice Address - Street 1:3520 SIMMERING SUN CT
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89081-4050
Practice Address - Country:US
Practice Address - Phone:702-910-8525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1247P-S104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker