| Sparkling Path Llc | |
|
1701 Bond St Brockway PA 15824-1705 | |
| (814) 503-0453 | |
| (814) 273-4037 |
| Full Name | Sparkling Path Llc |
|---|---|
| Speciality | Counselor |
| Location | 1701 Bond St, Brockway, Pennsylvania |
| Authorized Official Name and Position | Joan Elizabeth Crawford (COUNSELOR/MENTAL HEALTH THERAPIST) |
| Authorized Official Contact | 8145030453 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sparkling Path Llc 3487 Kearney Rd Brockway PA 15824-1063 Ph: (814) 503-0453 | Sparkling Path Llc 1701 Bond St Brockway PA 15824-1705 Ph: (814) 503-0453 |
| NPI Number | 1326807942 |
|---|---|
| Provider Enumeration Date | 03/18/2024 |
| Last Update Date | 12/13/2025 |
| Certification Date | 12/13/2025 |
| Medicare PECOS PAC ID | 8729427349 |
|---|---|
| Medicare Enrollment ID | O20240416001779 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326807942 | NPI | - | NPPES |
| 1326807942 | Medicaid | PA | |
| 1194357103 | Medicaid | PA | |
| 6N7418 | Medicaid | PA | |
| 6N7508 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Joan Elizabeth Crawford |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194357103 PECOS PAC ID: 5597109405 Enrollment ID: I20240220000441 |