| Spark Integrative Wellness, Pllc | |
|
2700 S Roan St Ste 300a Johnson City TN 37601-7556 | |
| (423) 722-2422 | |
| (423) 722-2400 |
| Full Name | Spark Integrative Wellness, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2700 S Roan St Ste 300a, Johnson City, Tennessee |
| Authorized Official Name and Position | Jennifer Judy (PMHNP) |
| Authorized Official Contact | 4234919146 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Spark Integrative Wellness, Pllc 2700 S Roan St Ste 300a Johnson City TN 37601-7556 Ph: (423) 722-2422 | Spark Integrative Wellness, Pllc 2700 S Roan St Ste 300a Johnson City TN 37601-7556 Ph: (423) 722-2422 |
| NPI Number | 1053121574 |
|---|---|
| Provider Enumeration Date | 01/08/2025 |
| Last Update Date | 01/08/2025 |
| Certification Date | 01/08/2025 |
| Medicare PECOS PAC ID | 9739619404 |
|---|---|
| Medicare Enrollment ID | O20250211000263 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053121574 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Jennifer Judy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326713280 PECOS PAC ID: 6204231764 Enrollment ID: I20210820001779 |
Summit Counseling Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4132 Bristol Hwy Ste 5, Johnson City, TN 37601 Phone: 423-946-1659 Fax: 423-283-4958 | |
The Journey Center For Healing Arts, Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 100 W Unaka Ave, Johnson City, TN 37604 Phone: 828-713-9003 | |
Mountain States Health Alliance Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 403 N State Of Franklin Rd, Johnson City, TN 37604 Phone: 423-431-7111 Fax: 423-431-7301 | |
Appalachian Counseling Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 807 Swadley Rd Apt 3, Johnson City, TN 37601 Phone: 423-948-9583 | |
Papillon Behavioral Health, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2514 1/2 Wesley St Ste 2, Johnson City, TN 37601 Phone: 423-529-0385 Fax: 423-414-2699 | |
Adult And Geriatric Psychiatry Service Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1618 Strawberry Ln, Johnson City, TN 37604 Phone: 423-677-6787 |