Provider Demographics
NPI:1124424858
Name:SPARKMAN, CATHERINE DANIELS (MS, LMHC, LPC)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:DANIELS
Last Name:SPARKMAN
Suffix:
Gender:F
Credentials:MS, LMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 MIDDLE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WILLOW SPRING
Mailing Address - State:NC
Mailing Address - Zip Code:27592-6821
Mailing Address - Country:US
Mailing Address - Phone:850-459-0667
Mailing Address - Fax:
Practice Address - Street 1:1904 MIDDLE RIDGE DR
Practice Address - Street 2:
Practice Address - City:WILLOW SPRING
Practice Address - State:NC
Practice Address - Zip Code:27592-6821
Practice Address - Country:US
Practice Address - Phone:850-459-0667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-06
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH 12226101YM0800X
FL14432101YM0800X
NC14666101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health