Organization · NPI-2

Bold Spark, INC.

Clinic/Center, Mental Health (Including Community Mental Health Center) · Streamwood, IL

NPI number1043072218
StatusActive
Last updated in NPPESMay 22, 2024

Details

NPI
1043072218
Entity type
Organization (NPI-2)
Legal business name
Bold Spark, INC.
Organization subpart
Yes
Enumeration date
Jan 24, 2024
Certification date
May 22, 2024
Last updated
May 22, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––Yes

Other names

  • The Oaks Counseling Center (Doing Business As)

Practice location

820 S Bartlett Rd Ste 106b
Streamwood, IL 60107-2407

Phone 224-318-7554

Mailing address

218 Gingerbrook Ln
Bartlett, IL 60103-4624

Phone 630-329-6709

Authorized official

Karen V. Liebold
Owner
6303296709

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Clinic/Center, Mental Health (Including Community Mental Health Center) providers in Streamwood, IL