Inner Spark Therapy LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

INNER SPARK THERAPY LLC

Practice address

134 S Wasson St
Coos Bay, OR 97420-3235

Phone

(971) 266-4355

NPI assigned

Aug 21, 2023

Organization subpart

No

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

Authorized official

Name

Corina Daugherty Calhoun, LCSW

Title

Owner, Therapist

Phone

(971) 266-4355

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692576000000",
    "number": "1295519312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1995 NEWMARK AVE # 1012",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974204727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 S WASSON ST",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974203235",
            "telephone_number": "971-266-4355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER SPARK THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A",
        "authorized_official_last_name": "DAUGHERTY CALHOUN",
        "authorized_official_first_name": "CORINA",
        "authorized_official_title_or_position": "OWNER, THERAPIST",
        "authorized_official_telephone_number": "971-266-4355",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Hutcheson
• Juliette Lynn Hyatt, PT
• Indigenous Healthcare Advancements, LLC
• Christopher Ingram, DO
• Jaime Ingram
• Allan A Inouye, M.D.
• Inspire Radiology Group 2 LLC
• Inspire Radiology Group LLC
• Io Wellness
• Bernadette Ireland, PMHNP

• Clinical Social Worker in Coos Bay, OR
• Providers in Coos Bay, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.

Verify at the official NPI Registry.