1275815458 NPI number — MS. NIKOLYA TRIONNE SPARKS LPC, CCTP-II, CAGS

Table of content: MS. NIKOLYA TRIONNE SPARKS LPC, CCTP-II, CAGS (NPI 1275815458)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275815458 NPI number — MS. NIKOLYA TRIONNE SPARKS LPC, CCTP-II, CAGS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SPARKS
Provider First Name:
NIKOLYA
Provider Middle Name:
TRIONNE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LPC, CCTP-II, CAGS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275815458
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/04/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
NIKOLYA T. SPARKS
Provider Second Line Business Mailing Address:
2117 VETERANS MEMORIAL BLVD, #141
Provider Business Mailing Address City Name:
METAIRIE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70002-6302
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-493-9326
Provider Business Mailing Address Fax Number:
888-220-7992

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4862 FELICIANA DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW ORLEANS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70126-4704
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-493-9326
Provider Business Practice Location Address Fax Number:
888-220-7992
Provider Enumeration Date:
09/14/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  2739 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: 2739 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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