Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Sparkle L Nicks

Individual provider Marriage & Family Therapist · NPI 1124627005

Sparkle L Nicks is a Marriage & Family Therapist in Peoria, Illinois. Registered with an NPI since 2020.

In the registry since
2020

Practice location Address checks out

10508 Churchill Dr
Peoria, IL 61615-1178
Phone: (309) 706-3676
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X

Record details

NPI number1124627005
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 21, 2020
Last updated in NPPESOctober 21, 2020
Certification dateOctober 21, 2020
Mailing address2610 W Richwoods Blvd, Peoria, IL 61604-7112

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