BOLD SPARK, INC. – NPI #1043072218
Clinic/Center

BOLD SPARK, INC. is a AHC clinic located in STREAMWOOD, IL. NPPES recently assigned the NPI number 1043072218 to BOLD SPARK, INC. on January 24, 2024. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QM0801X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center specializing in Mental Health (Including Community Mental Health Center)

The NPI profile was last updated on Jan 25, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BOLD SPARK, INC. below.

NPI Profile for
BOLD SPARK, INC.

NPI Number
1043072218
Created

(about 5 weeks ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BOLD SPARK, INC.
Primary location
820 S BARTLETT RD STE 106B
STREAMWOOD, IL 60107-2407
Phone: (224) 318-7554 Fax:
Mailing address
218 GINGERBROOK LN
BARTLETT, IL 60103-4624
Phone: (630) 329-6709 Fax:
Organization Subpart
Yes - BOLD SPARK, INC. is subpart of another organization.
Authorized Official
KAREN LIEBOLD
OWNER
Phone: (630) 329-6709
Updated
Certification Date
Jan 25, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for BOLD SPARK, INC.

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
otherNPI1245414465
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QM0801X
- Clinic/Center / Mental Health (Including Community Mental Health Center) (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.