NPIMap

Organization Active NPI

Sparkle Healing LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hyattsville, MD
National Provider Identifier
1053038562
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
SPARKLE HEALING LLC
Practice address
4328 Farragut St
Hyattsville, MD 20781-2032
Phone
(240) 685-1940
NPI assigned
Oct 25, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Authorized official

Name
Tyler Mabry, LCPCNPI 1821592247
Title
Ceo/Clinical Director
Phone
(240) 685-1940

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

4328 Farragut St
Hyattsville, MD 20781-2032

Mailing address

4328 Farragut St
Hyattsville, MD 20781-2032

National Provider Directory

National Provider Directory

Locations

4328 Farragut St
Hyattsville, MD 20781
Phone (240) 685-1940

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1666656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666656000000",
    "number": "1053038562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4328 FARRAGUT ST",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207812032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4328 FARRAGUT ST",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207812032",
            "telephone_number": "240-685-1940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARKLE HEALING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-25",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A",
        "authorized_official_last_name": "MABRY",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "CEO/CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "240-685-1940",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyattsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.