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SPARK INTEGRATIVE WELLNESS, PLLC
NPI 1053121574
Clinic/Center - Mental Health (Including Community Mental Health Center) in Johnson City, TN

Active since January 08, 2025
2700 S ROAN ST STE 300A, JOHNSON CITY, TN 37601(423) 722-2422(423) 722-2400 Get Directions Write a Review

NPPES record last updated: January 8, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Spark Integrative Wellness, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SPARK INTEGRATIVE WELLNESS, PLLC (NPI 1053121574) is a healthcare organization registered as a mental health (including community mental health center) in Johnson City, Tennessee and active in the NPI registry since January 2025. The organization lists Jennifer Judy, Pmhnp, as its authorized official.

NPPES Registry Identity

NPI1053121574
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameSPARK INTEGRATIVE WELLNESS, PLLC
Location Address2700 S ROAN ST STE 300AJohnson City, TN 37601-7556
Mailing Address2700 S Roan St Ste 300aJohnson City, TN 37601-7556 · (423) 722-2422 · Fax (423) 722-2400
Phone(423) 722-2422
Fax(423) 722-2400
Organization SubpartNo
Authorized OfficialJennifer JudyPmhnp · (423) 491-9146
Enumeration DateJanuary 8, 2025
NPPES CertifiedJanuary 8, 2025
✔ NPI 1053121574 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
2700 S ROAN ST STE 300A, Johnson City, TN 37601
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. JENNIFER D JUDY PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
2700 S ROAN ST STE 300A
JOHNSON CITY, TN 37601
Washington County (423) 491-9146

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Spark Integrative Wellness, PLLC's NPI number?

The NPI number for Spark Integrative Wellness, PLLC is 1053121574. It was assigned to this organization in the NPPES registry on January 8, 2025.

Where is Spark Integrative Wellness, PLLC located?

Spark Integrative Wellness, PLLC is located at 2700 S Roan St Ste 300A, Johnson City, TN 37601. The listed phone number is (423) 722-2422.

What is Spark Integrative Wellness, PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

When was this NPI record last updated?

The NPPES record for Spark Integrative Wellness, PLLC was last updated on January 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.