Seaside Psychological Assessments and Resources for Kids PLLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

SEASIDE PSYCHOLOGICAL ASSESSMENTS AND RESOURCES FOR KIDS PLLC

Doing business as

SPARKids

Practice address

4902 Main St Ste D
Shallotte, NC 28470-4749

Phone

(910) 754-2289

NPI assigned

Oct 20, 2025

Last updated

Aug 10, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tia Cornwall, ED.S., LPANPI 1710488408

Title

Partner

Phone

(540) 314-0606

Specialties & licenses 1

Addresses

Other names 1

• SPARKids Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tia Cornwall, ED.S., LPA

  • Psychologist
  • Shallotte, NC
  • NPI 1710488408
  NPD Authorized official

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

{
    "created_epoch": "1760918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786320000000",
    "number": "1902773682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1023",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284591023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4902 MAIN ST STE D",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284704749",
            "telephone_number": "910-754-2289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEASIDE PSYCHOLOGICAL ASSESSMENTS AND RESOURCES FOR KIDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-20",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A",
        "authorized_official_last_name": "CORNWALL",
        "authorized_official_first_name": "TIA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "540-314-0606",
        "authorized_official_credential": "ED.S., LPA"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SPARKids",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Heather Sue Schaefer, MA., LCAS-A
• Tiffany Lewis Scheib, P.A.
• Courtney Ann Schriever, OTR/L
• Heidi Ann Schroeder, FNP
• Brenda A Scronce, PA-C
• Karla Melissa Sebastian, OTR/L
• Britton Seivert, LPC LCMHCA
• Haley Sellers, BSN RN IBCLC
• Samantha Sessoms, LCASA
• Shallotte Chiropractic Balance and Wellness PLLC

• Psychologist in Shallotte, NC
• Providers in Shallotte, NC by specialty
• Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.