Clayton Sparks, LMHC, LCAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

39003190A Issued in IN

Practice address

5470 E 16TH St
Indianapolis, IN 46218-4861

Phone

(317) 621-5700

Fax

(317) 621-5991

NPI assigned

Jan 5, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: csparks305079@ecommunitydirect.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Centerstone of Indiana, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bloomington, IN
  • NPI 1972320224
  NPD (past)

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

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1225494420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5470 E 16TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462184861",
            "telephone_number": "317-621-5700",
            "fax_number": "317-621-5991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1175 Southview Dr",
            "address_purpose": "LOCATION",
            "city": "Martinsville",
            "state": "IN",
            "postal_code": "461517062",
            "country_code": "US",
            "telephone_number": "765-342-6616",
            "fax_number": "765-342-2169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "CLAYTON",
        "credential": "LMHC, LCAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-05",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "86000122A",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39003190A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CSPARKS305079@ECOMMUNITYDIRECT.COM",
            "affiliation": "N",
            "address_1": "5470 E 16th St",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462184861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Spark Recovery of Indiana
• Mary Jo Sparke, LCSW
• Aaron Sparks, DPT
• Adrienne Michelle Sparks, PA
• Brandon Arnold Sparks, M.D.
• Danielle Grace Sparks, OTR
• Jenna Renee Sparks, LAT, ATC
• John Calvin Sparks
• Kathleen Malone Sparks, ATC, LAT
• Kimberly Ann Sparks, MS CCC SLP

• Mental Health Counselor in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.