| Scottye Sparks, LPCC | |
|
4414 Old Lagrange Rd, Buckner, KY 40010-9547 | |
| (502) 222-2389 | |
| (502) 222-2927 |
| Full Name | Scottye Sparks |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 4414 Old Lagrange Rd, Buckner, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447633839 | NPI | - | NPPES |
| 7100879980 | Medicaid | KY |
| Entity Name | Grow Healthcare Group Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20220604000237 |
| Entity Name | Prodigal Ministries Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013662717 PECOS PAC ID: 2860840493 Enrollment ID: O20231121000960 |
| Mailing Address | Practice Location Address |
|---|---|
| Scottye Sparks, LPCC Po Box 1484, Crestwood, KY 40014-1484 Ph: (502) 222-2389 | Scottye Sparks, LPCC 4414 Old Lagrange Rd, Buckner, KY 40010-9547 Ph: (502) 222-2389 |
Ashley Stump, CADCA1 Counselor Medicare: Not Enrolled in Medicare Practice Location: 4414 Old Lagrange Rd, Buckner, KY 40010 Phone: 502-222-2389 | |
Rodney Frederick, LPCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 4414 Old Lagrange Rd, Buckner, KY 40010 Phone: 502-222-2389 | |
Brittanni Mcmanaway, LPCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 4414 Old Lagrange Rd, Buckner, KY 40010 Phone: 502-222-2389 | |
Michael Henney, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4414 Old Lagrange Rd, Buckner, KY 40010 Phone: 502-222-2389 Fax: 502-222-2927 | |
Deenie Pelfrey, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4414 Old Lagrange Rd, Buckner, KY 40010 Phone: 502-222-2389 | |
Bryan Purcell, LPCC Counselor Medicare: Medicare Enrolled Practice Location: 4414 Old La Grange Rd, Buckner, KY 40010 Phone: 502-222-2389 Fax: 502-222-2927 |