Provider Demographics
NPI:1154016103
Name:SPARK LITTLE MINDS
Entity type:Organization
Organization Name:SPARK LITTLE MINDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALMONTE FERMIN
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP, TSSLD
Authorized Official - Phone:914-893-5353
Mailing Address - Street 1:PO BOX 2492
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06906-0492
Mailing Address - Country:US
Mailing Address - Phone:203-516-7005
Mailing Address - Fax:866-428-6699
Practice Address - Street 1:20 SECOR PL APT 2T
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-3230
Practice Address - Country:US
Practice Address - Phone:203-516-7005
Practice Address - Fax:866-428-6699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251B00000XAgenciesCase Management