Sparks of Light Psychotherapy, PLLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

SPARKS OF LIGHT PSYCHOTHERAPY, PLLC

Practice address

123 Harvard Ave
Pueblo, CO 81004-1223

Phone

(918) 658-8352

NPI assigned

Dec 11, 2024

Organization subpart

No

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

Authorized official

Name

Paitton Nicole Kendrick Callery, LPC, ATR-PNPI 1538589254

Title

Owner/Solo Practitioner

Phone

(918) 658-8352

Specialties & licenses 1

Addresses

Practitioners 1

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

• Paitton Nicole Kendrick-Callery

  • Counselor
  • Pueblo, CO
  • NPI 1538589254
  NPD Authorized official

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

{
    "created_epoch": "1733875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736208000000",
    "number": "1477360600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 HARVARD AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810041223",
            "telephone_number": "918-658-8352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 HARVARD AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810041223",
            "telephone_number": "918-658-8352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARKS OF LIGHT PSYCHOTHERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-11",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A",
        "authorized_official_last_name": "KENDRICK CALLERY",
        "authorized_official_first_name": "PAITTON",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER/SOLO PRACTITIONER",
        "authorized_official_telephone_number": "918-658-8352",
        "authorized_official_credential": "LPC, ATR-P"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spanish Peaks Mental Health Center
• Spanish Peaks New Alternatives, Inc.
• Spanish Peaks New Alternatives, Inc.
• Spanish Peaks New Alternatives, Inc.
• Lynda A Spann, PH.D.
• Sparks Residential and Support Services, Inc
• Melissa R. Sparks, PTA
• Penny Sue Spearing, MA, LPC
• Specialized Inpatient Medical Services, LLC
• Spectrum of Light Family Services, LLC

• Professional Counselor in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Professional Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; 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.