Spark Counseling Center, LLC
NPI #1942767140 in Gulfport, Mississippi
Provider Information
- NPI Number
- 1942767140
- Entity Type
- Organization
- Organization Name
- Spark Counseling Center, LLC
- Primary Specialty
- Counselor - Mental Health
- Enumeration Date
- Feb 23, 2019
- Last Updated
- Feb 23, 2019
Practice Location
- Address
- 3427 WASHINGTON AVE
- City
- Gulfport
- State
- Mississippi
- ZIP Code
- 39507-3039
- Phone
- (504) 300-9811
Authorized Official
- Name
- MARY DODSON, LMFT
- Title
- REGISTERED AGENT/OWNER
- Phone
- (504) 300-9811
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center) |
| Clinic/Center - Adult Mental Health — Adult Mental Health |
| Counselor - Mental Health — Mental Health |
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