KEA RESHUN SPARKMAN LPC
NPI 1669750519
Counselor - Professional in Lawrenceville, GA
Active since July 26, 2011
About Kea Reshun Sparkman Lpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KEA RESHUN SPARKMAN LPC (NPI 1669750519) is an individual professional provider in Lawrenceville, Georgia, licensed in Georgia (LPC006043) and active in the NPI registry since July 2011.
NPPES Registry Identity
NPI1669750519
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameKEA RESHUN SPARKMANCredential: LPC
Location Address3355 SWEETWATER RD, APT. 10206Lawrenceville, GA 30044-8544
Mailing Address3355 Sweetwater Rd, Apt. 10206Lawrenceville, GA 30044-8544 · (770) 820-5755
Phone(770) 820-5755
Sole ProprietorYes
Enumeration DateJuly 26, 2011
Last NPPES UpdateAugust 9, 2011
✔ NPI 1669750519 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in GA · LPC006043
3355 SWEETWATER RD, Lawrenceville, GA 30044
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1669750519, enumerated as an "individual" on July 26, 2011.
The provider is located at 3355 SWEETWATER RD APT. 10206 LAWRENCEVILLE, GA 30044 and the phone number is (770) 820-5755.
Counselor with taxonomy code 101YP2500X and a focus in Professional.
