Spark Behavioral Health LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

SPARK BEHAVIORAL HEALTH LLC

Practice address

11000 SW Barbur Blvd Ste 100
Portland, OR 97219-8691

Phone

(971) 228-9848

NPI assigned

Dec 10, 2024

Organization subpart

No

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

Authorized official

Name

Timnit Yikealo

Title

Co-Ceo

Phone

(971) 228-9848

Specialties & licenses 1

Addresses

Other names 1

• Spark Behavioral Health LLC Doing business as

Locations

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

{
    "created_epoch": "1733788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781136000000",
    "number": "1376359695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 SW BETTS AVE # 44",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970052869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11000 SW BARBUR BLVD STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972198691",
            "telephone_number": "971-228-9848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10354 NE Wasco St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972203927",
            "country_code": "US",
            "telephone_number": "971-228-9848",
            "fax_number": "503-907-6855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPARK BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-10",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A",
        "authorized_official_last_name": "YIKEALO",
        "authorized_official_first_name": "TIMNIT",
        "authorized_official_title_or_position": "CO-CEO",
        "authorized_official_telephone_number": "971-228-9848"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spark Behavioral Health LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Spark Behavioral Health LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelly Ann Span, CADC I
• Anna Nicole Spangler, LMT
• Judy Elizabeth Spaniol Turner, PT
• Anna Gabriele Gregory Spann, RN, CNM, NP
• Stephanie Spann, MSW
• Spark Relational Counseling, LLC
• John Philip Allen Sparkenbach
• Sparking Hope LLC
• Young Sparkman
• Sparks Chiropractic LLC

• Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2026; 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.