Provider Demographics
NPI:1861219784
Name:SPARKS, CHELLSEA (MA, LPC-ASSOSCIATE)
Entity type:Individual
Prefix:
First Name:CHELLSEA
Middle Name:
Last Name:SPARKS
Suffix:
Gender:F
Credentials:MA, LPC-ASSOSCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5204 WHILE A WAY RD
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-5750
Mailing Address - Country:US
Mailing Address - Phone:806-680-3695
Mailing Address - Fax:888-392-2231
Practice Address - Street 1:4200 RIDGECREST CIR STE B
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-5416
Practice Address - Country:US
Practice Address - Phone:806-680-3695
Practice Address - Fax:888-392-2231
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX93664101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor