Provider Demographics
NPI:1538303771
Name:SPARKS, SHERELL MARIE (MS, CRC, LCPC)
Entity type:Individual
Prefix:
First Name:SHERELL
Middle Name:MARIE
Last Name:SPARKS
Suffix:
Gender:F
Credentials:MS, CRC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 PARADISE LN
Mailing Address - Street 2:
Mailing Address - City:METROPOLIS
Mailing Address - State:IL
Mailing Address - Zip Code:62960-2413
Mailing Address - Country:US
Mailing Address - Phone:186-203-2799
Mailing Address - Fax:186-524-2670
Practice Address - Street 1:101 E DEYOUNG ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959-3128
Practice Address - Country:US
Practice Address - Phone:618-693-9139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-30
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator