Provider Demographics
NPI:1861376477
Name:SPARROW MENTAL HEALTH PLLC
Entity type:Organization
Organization Name:SPARROW MENTAL HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MIRANDA
Authorized Official - Middle Name:JUNE
Authorized Official - Last Name:CLEMONS
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:817-301-6277
Mailing Address - Street 1:888 CASINO RD
Mailing Address - Street 2:
Mailing Address - City:NOCONA
Mailing Address - State:TX
Mailing Address - Zip Code:76255-0940
Mailing Address - Country:US
Mailing Address - Phone:817-301-6277
Mailing Address - Fax:
Practice Address - Street 1:2525 KELL BLVD STE 302
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76308-1049
Practice Address - Country:US
Practice Address - Phone:940-432-3444
Practice Address - Fax:940-432-5558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty