| Spark Counseling Pllc | |
|
917 S Main St Lombard IL 60148-3347 | |
| (630) 446-0306 | |
| (630) 601-2877 |
| Full Name | Spark Counseling Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 917 S Main St, Lombard, Illinois |
| Authorized Official Name and Position | Jennifer Tewell (OWNER) |
| Authorized Official Contact | 6304460306 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spark Counseling Pllc 917 S Main St Lombard IL 60148-3347 Ph: (630) 446-0306 | Spark Counseling Pllc 917 S Main St Lombard IL 60148-3347 Ph: (630) 446-0306 |
| NPI Number | 1922624931 |
|---|---|
| Provider Enumeration Date | 06/25/2020 |
| Last Update Date | 06/25/2020 |
| Certification Date | 06/25/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922624931 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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