Mary Jo Sparke, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34004679A Issued in IN

Practice address

8320 Madison Ave
Indianapolis, IN 46227-6066

Phone

(317) 882-5122

Fax

(317) 888-8642

NPI assigned

Jan 22, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207008000000",
    "number": "1043364946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8320 MADISON AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462276066",
            "telephone_number": "317-882-5122",
            "fax_number": "317-888-8642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8320 MADISON AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462276066",
            "telephone_number": "317-882-5122",
            "fax_number": "317-888-8642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARKE",
        "first_name": "MARY",
        "middle_name": "JO",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2008-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004679A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Rae Spangler, MS
• Tanea Renee Spanton, PTA
• Michele R Spargur, NP
• Spark Dental in, LLC
• Spark Recovery of Indiana
• Aaron Sparks, DPT
• Adrienne Michelle Sparks, PA
• Brandon Arnold Sparks, M.D.
• Clayton Sparks, LMHC, LCAC
• Danielle Grace Sparks, OTR

• Clinical Social Worker in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.