Stephanie T. Snow, PH.D., LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

003376 Issued in CT

Legal business name

STEPHANIE T. SNOW, PH.D., LLC

Practice address

1169 Ellington Rd
South Windsor, CT 06074-3515

Phone

(860) 404-6006

NPI assigned

Oct 7, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Stephanie T. Snow, PH.D.NPI 1912275744

Title

Psychologist, Owner

Phone

(860) 404-6006

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephanie Snow, PH.D.

  • Clinical Psychologist
  • South Windsor, CT
  • NPI 1912275744
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728000000000",
    "number": "1083085740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8397",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060400397",
            "telephone_number": "860-404-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1169 ELLINGTON RD",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060743515",
            "telephone_number": "860-404-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHANIE T. SNOW, PH.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-07",
        "last_updated": "2024-10-04",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "SNOW",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "PSYCHOLOGIST, OWNER",
        "authorized_official_telephone_number": "860-404-6006",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "003376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in South Windsor, CT
• Providers in South Windsor, CT by specialty
• Clinical Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.