KENNETH JOHN SPARKS (LMSW) – Social Worker, NPI 1154894756

KENNETH JOHN SPARKS (LMSW) is a healthcare provider. based in Kalamazoo, Michigan. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LMSW. They hold a License No. 6801105565 (MI). The NPI Number for KENNETH JOHN SPARKS (LMSW) is 1154894756

Main info

Male
12 Years Of Experience
Accepts Medicare Assignment
Name
KENNETH JOHN SPARKS (LMSW)
NPI
1154894756
Phone
Not provided
Address
222 N KALAMAZOO MALL STE 100
Enumeration Date
7 January 2019
Last Update Date
17 December 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2696736617
Graduation Year
2014 (12 years ago)
PAC ID
3173052818
Group Practice PAC ID
1153317607
Professional Enrollment ID
I20250127000397
Address ID
MI490101517AL540XXDRXX300
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:7State licenses:1Digital endpointsOther names

4,820 CLINICAL SOCIAL WORKER in MI

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Provider Addresses for KENNETH JOHN SPARKS (LMSW)

  • 100, Kalamazoo Mall, Kalamazoo, Kalamazoo County, Michigan, 49007, United States

    KALAMAZOO, MI 490073899

    Phone:

    Type: Mailing

  • 540 JENNER DR

    ALLEGAN, MI 490101517

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-01-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250127000397IClinical Social WorkerMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49007)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1153317607View full group profile
NameSpecialtyState
Clinical Social WorkerMI
Clinical Social WorkerMI
Nurse PractitionerMI
Mental Health CounselorMI
Clinical Social WorkerMI
Clinical Social WorkerMI
Clinical Social WorkerMI
Mental Health CounselorMI
Nurse PractitionerMI
Addiction Medicine, Emergency MedicineIL

Reviews

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Frequently asked questions

How is KENNETH JOHN SPARKS (LMSW) identified in CMS data?
CMS-hosted NPPES data lists KENNETH JOHN SPARKS (LMSW) with NPI 1154894756.
Can I rely on KENNETH JOHN SPARKS (LMSW) being an active provider?
As of the registry snapshot, KENNETH JOHN SPARKS (LMSW) is marked active.
What is KENNETH JOHN SPARKS (LMSW)'s primary classification?
Social Worker is the headline specialty for KENNETH JOHN SPARKS (LMSW) here. Clinical services aligned with this taxonomy classification.
What area does KENNETH JOHN SPARKS (LMSW) serve?
KENNETH JOHN SPARKS (LMSW)'s listing highlights Kalamazoo, Michigan; more addresses can appear in NPPES.
How many locations tie to this NPI?
4 practice locations appear in the available data.

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