Provider Demographics
NPI:1871138651
Name:PRODOS COUNSELING, LLC
Entity type:Organization
Organization Name:PRODOS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SOPHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPARKS
Authorized Official - Suffix:
Authorized Official - Credentials:LSW,LPC
Authorized Official - Phone:513-457-1616
Mailing Address - Street 1:8080 BECKETT CENTER DR STE 326
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-5042
Mailing Address - Country:US
Mailing Address - Phone:513-457-1616
Mailing Address - Fax:
Practice Address - Street 1:8080 BECKETT CENTER DR STE 326
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-5042
Practice Address - Country:US
Practice Address - Phone:513-457-1616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-15
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty