RICKEY JOE SPARKS (NPI# 1184935280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184935280 |
| Entity Type | Individual |
| Full Name | RICKEY JOE SPARKS |
| Credential | PHD |
| Practice Address |
904 W South Park Blvd Broken Arrow OK 74011-2042 |
| Practice Telephone | 9184552714 |
| Mailing Telephone | 9184552714 |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2010-06-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
391 | OK | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
1588 | OK | Behavioral Health & Social Service Providers |
| Street Address |
904 W SOUTH PARK BLVD |
| City | BROKEN ARROW |
| State | OK |
| Zip Code | 74011-2042 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336663699 | Cpii, LLC | Pharmacy | 811 W. New Orleans, Ste 101, Broken Arrow, OK 74011 | 2017-07-28 |
| 1053833608 | Cpii, LLC | Pharmacy | 811 W. New Orleans, Suite 101, Broken Arrow, OK 74011 | 2017-07-14 |
| 1184079709 | Melissa David | Lactation Consultant, Non-RN | 417 West San Diego St., Broken Arrow, OK 74011 | 2016-05-02 |
| 1154789576 | Rebecca Young | Registered Nurse | 7801 S Oak Pl, Broken Arrow, OK 74011 | 2016-01-29 |
| 1942524061 | Oklahoma Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 751 W Tuscan St, 121st, Broken Arrow, OK 74011 | 2010-03-18 |
| 1174764336 | Linda J. Russell | Counselor | 2446 W New Orleans St, Broken Arrow, OK 74011 | 2009-03-18 |
| 1851409080 | Kim Lee Mcneal | Dentist | 3764 South Elm Place, Broken Arrow, OK 74011 | 2006-08-28 |
| 1669433249 | Matthew E Ozment | Optometrist | 2500 West New Orleans, Broken Arrow, OK 74011 | 2006-03-31 |
| 1912275140 | Courtney Brooke Willcoxon | Pharmacist | 4704 S Elm Pl, Broken Arrow, OK 74011 | 2011-12-02 |
| 1558322883 | Gerald Seefeldt | Family Medicine | 66 Cedar Ridge Rd, Broken Arrow, OK 74011-1101 | 2006-03-28 |
| Find all providers in zip 74011 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225658321 | Individual and Family Matters LLC. | Counselor | 20216 E 43rd Pl S, Broken Arrow, OK 74014-1595 | 2020-04-20 |
| 1043871213 | Stacy Lynn Mitchell | Counselor | 2035 W. Houson St., Suite A, Broken Arrow, OK 74012 | 2019-06-27 |
| 1467010074 | Candice Collins | Counselor | 6501 S Garnett Rd, Broken Arrow, OK 74012-8529 | 2019-05-30 |
| 1215492400 | Amanda Jeanne Lee | Counselor | 29815 E 36th St S, Broken Arrow, OK 74014-8325 | 2019-02-01 |
| 1417496027 | Angela Moore | Counselor | 905 S 30th St, Broken Arrow, OK 74014-2848 | 2017-02-15 |
| 1841744356 | Dianna Lynn Schrimsher | Counselor | 410 N Palm Ct, Broken Arrow, OK 74012-2175 | 2016-08-12 |
| 1902266059 | Gamaliel Mananga | Counselor | 314 S Sycamore Pl, Broken Arrow, OK 74012-8367 | 2016-03-02 |
| 1659742997 | Amanda Hall | Counselor | 9545 Clearview Dr, Broken Arrow, OK 74014-3269 | 2015-10-13 |
| 1699190298 | Jennifer Johnson | Counselor | 2612 W Decatur St, Broken Arrow, OK 74011-6123 | 2014-02-19 |
| 1982033692 | Chris Jones | Counselor | 21560 E 161st St S, Broken Arrow, OK 74014-6446 | 2013-11-03 |
| Find all providers in BROKEN ARROW | ||||
| City | BROKEN ARROW |
| Zip Code | 74011 |
Please comment or provide details below to improve the information on RICKEY JOE SPARKS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.