Courtney Sparkuhl, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

83219 Issued in CA

Practice address

25422 Trabuco Rd Ste 105-302
Lake Forest, CA 92630-2791

Phone

(949) 329-4616

NPI assigned

Jan 18, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649376000000",
    "number": "1043581440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25422 TRABUCO RD STE 105-302",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926302791",
            "telephone_number": "949-329-4616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25422 TRABUCO RD STE 105-302",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926302791",
            "telephone_number": "949-329-4616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARKUHL",
        "first_name": "COURTNEY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-18",
        "last_updated": "2022-04-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "83219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.