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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

SPARK CHANGE WELLNESS CENTER, LLC
NPI 1992617963
Counselor - Mental Health in Gambrills, MD

Active since September 22, 2026
331 GAMBRILLS RD STE 4B, GAMBRILLS, MD 21054(410) 864-0201 Get Directions Write a Review

NPPES record added: September 22, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

About Spark Change Wellness Center, Llc NPPES

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

SPARK CHANGE WELLNESS CENTER, LLC (NPI 1992617963) is a healthcare organization registered as a mental health in Gambrills, Maryland and active in the NPI registry since September 2026. The organization lists Renee Mack, Psychologist, as its authorized official.

NPPES Registry Identity

NPI1992617963
Entity TypeOrganization
Primary Taxonomy101YM0800X
Legal Business NameSPARK CHANGE WELLNESS CENTER, LLC
Location Address331 GAMBRILLS RD STE 4BGambrills, MD 21054-1141
Mailing Address331 Gambrills Rd Ste 4bGambrills, MD 21054-1141
Phone(410) 864-0201
Organization SubpartNo
Authorized OfficialRenee MackPsychologist · (302) 898-1720
Enumeration DateSeptember 22, 2026
NPPES CertifiedSeptember 22, 2026
✔ NPI 1992617963 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
331 GAMBRILLS RD STE 4B, Gambrills, MD 21054
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

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

DR. LA TOYA BIANCA SMITH PHD
Psychologist (Clinical)
331 GAMBRILLS RD STE 4B
GAMBRILLS, MD 21054
Anne Arundel County (410) 989-3558
INDONESIA CARTER
Social Worker
331 GAMBRILLS RD STE 4B
GAMBRILLS, MD 21054
Anne Arundel County (443) 569-8882
DR. LARAY IMANI PRICE PH.D. - PSYCHOLOGIST
Psychologist
331 GAMBRILLS RD STE 4B
GAMBRILLS, MD 21054
Anne Arundel County (443) 569-8882
MR. ARAS LEON VANBIBBER JR.
Psychologist (Counseling)
331 GAMBRILLS RD STE 4B
GAMBRILLS, MD 21054
Anne Arundel County (443) 569-8882

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 Change Wellness Center, LLC's NPI number?

The NPI number for Spark Change Wellness Center, LLC is 1992617963. It was assigned to this organization in the NPPES registry on September 22, 2026.

Where is Spark Change Wellness Center, LLC located?

Spark Change Wellness Center, LLC is located at 331 Gambrills Rd Ste 4B, Gambrills, MD 21054. The listed phone number is (410) 864-0201.

What is Spark Change Wellness Center, LLC's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Spark Change Wellness Center, LLC was last updated on September 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 days 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.