Sparkle Wellness, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SPARKLE WELLNESS, LLC

Practice address

1214 Post Rd
Fairfield, CT 06824-6008

Phone

(203) 516-7080

NPI assigned

Jun 8, 2021

Organization subpart

No

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

Authorized official

Name

Marsha Polanco, LCSWNPI 1659925642

Title

Owner

Phone

(203) 516-7080

Specialties & licenses 1

Addresses

Other names 1

• Marsha Polanco, LCSW Doing business as

Electronic endpoints 1

Locations

Practitioners 1

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

• Marsha Mariana Polanco

  • Clinical Social Worker
  • Fairfield, CT
  • NPI 1659925642
  NPD Authorized official

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623110400000",
    "number": "1730756743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 BOSTON POST RD # 3-553",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064602578",
            "telephone_number": "203-516-7080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1214 POST RD",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246008",
            "telephone_number": "203-516-7080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARKLE WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-08",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A",
        "authorized_official_last_name": "POLANCO",
        "authorized_official_first_name": "MARSHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-516-7080",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Fairfield",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1214 Post Rd",
            "city": "Fairfield",
            "state": "CT",
            "country_code": "US",
            "postal_code": "068246008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Marsha Polanco, LCSW",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Amy M Sparks, OT
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• Jessica Speed, PT, DPT
• Jonathan Alan Speicher
• Evelyn Spencer, DMD

• Clinical Social Worker in Fairfield, CT
• Providers in Fairfield, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; 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.