Basic Information
| Provider Information | |||||||||
| NPI: | 1245736099 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SNAPP | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | EDWARD | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1016 | ||||||||
| Address2: | |||||||||
| City: | HAPPY CAMP | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960391016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5304931600 | ||||||||
| FaxNumber: | 5304931648 | ||||||||
| Practice Location | |||||||||
| Address1: | 1515 S OREGON ST | ||||||||
| Address2: | |||||||||
| City: | YREKA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960973475 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308413141 | ||||||||
| FaxNumber: | 5308415150 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/02/2018 | ||||||||
| LastUpdateDate: | 04/02/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LCSW79300 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | LCSW79300 | 01 | CA | CALIFORNIA LCSW LICENSE | OTHER |