Provider Demographics
NPI:1114496676
Name:SPARKS, MARGARITA (LLMSW)
Entity type:Individual
Prefix:
First Name:MARGARITA
Middle Name:
Last Name:SPARKS
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6425 SCHAEFER RD STE 2
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-1974
Mailing Address - Country:US
Mailing Address - Phone:313-846-2606
Mailing Address - Fax:313-846-2657
Practice Address - Street 1:6425 SCHAEFER RD STE 2
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-1974
Practice Address - Country:US
Practice Address - Phone:313-846-2606
Practice Address - Fax:313-846-2657
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-14
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical