Provider Demographics
NPI:1396329223
Name:BRIGHTSPARK THERAPY AND CONSULTING
Entity type:Organization
Organization Name:BRIGHTSPARK THERAPY AND CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:S
Authorized Official - Last Name:FLANSBURG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCP
Authorized Official - Phone:804-668-7220
Mailing Address - Street 1:9025 FOREST HILL AVE STE 2A
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-3025
Mailing Address - Country:US
Mailing Address - Phone:804-668-7220
Mailing Address - Fax:
Practice Address - Street 1:801 N 27TH ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-6507
Practice Address - Country:US
Practice Address - Phone:804-668-7220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-06
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty