Individual provider Active NPI

Elizabeth Ann Sparks, LLPC

  • Professional Counselor
  • Jackson, MI
National Provider Identifier
1699910919
Registry record updated Dec 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401010712 Issued in MI
Practice address
1218 Greenwood Ave
Jackson, MI 49203-3037
Phone
(517) 990-0596
Fax
(517) 990-1280
NPI assigned
Dec 16, 2008
Last updated
Dec 16, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401010712 MI Primary

Addresses

Primary practice location

1218 Greenwood Ave
Jackson, MI 49203-3037

Mailing address

1200 N West Ave
Suite 400
Jackson, MI 49202-2179
Phone (517) 780-3336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6401010712MIMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1229385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229385600000",
    "number": "1699910919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N WEST AVE",
            "address_2": "SUITE 400",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022179",
            "telephone_number": "517-780-3336",
            "fax_number": "517-796-4561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 GREENWOOD AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492033037",
            "telephone_number": "517-990-0596",
            "fax_number": "517-990-1280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "LLPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-16",
        "last_updated": "2008-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401010712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2008; 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.