Active NPI
Destyny Sparks
- Mental Health Counselor
- Atlanta, GA
National Provider Identifier
1013796598
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1030 Fayetteville Rd SE
Atlanta, GA 30316-2921 - Phone
- (404) 486-9034
- NPI assigned
- Sep 25, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | GA | Primary |
Addresses
Primary practice location
1030 Fayetteville Rd SE
Atlanta, GA 30316-2921
Mailing address
5808 Hackberry LN
Braselton, GA 30517-5114
Phone (850) 631-6298
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695600000000",
"number": "1013796598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5808 HACKBERRY LN",
"city": "BRASELTON",
"state": "GA",
"postal_code": "305175114",
"telephone_number": "850-631-6298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1030 FAYETTEVILLE RD SE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303162921",
"telephone_number": "404-486-9034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPARKS",
"first_name": "DESTYNY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-09-25",
"last_updated": "2023-09-25",
"certification_date": "2023-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "GA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.