Theresa A. Sparks, PH.D., Inc.
NPI 1679955181ActiveOrganization· Psychologist, Clinical· Fernandina Beach, FL
Psychologist, Clinical in Fernandina Beach, Florida, registered in NPPES in June 2015. The authorized official on file is Theresa A. Sparks, PH.D., President/Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1679955181 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 20, 2015 |
| Last updated in NPPES | Jun 11, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | PY9173 | FL |
| Psychologist, Clinical | 103TC0700X | PSY002794 | GA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (FL) |
|---|
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