Organization Active NPI

Steven Snook, PH.D., LLC

  • Psychologist
  • College Park, GA
National Provider Identifier
1093048324
Registry record updated Nov 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY0001477 Issued in GA
Legal business name
STEVEN SNOOK, PH.D., LLC
Practice address
1651 Phoenix Blvd Ste 2
College Park, GA 30349-5552
Phone
(770) 997-1738
Fax
(770) 991-1375
NPI assigned
Sep 18, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2012

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

Authorized official

Name
Paula Sroka
Title
Office Administrator
Phone
(770) 997-1738

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X LPC003891 GA
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X LPC0006197 GA
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X PSY0001477 GA Primary

Addresses

Primary practice location

1651 Phoenix Blvd Ste 2
College Park, GA 30349-5552

Mailing address

1651 Phoenix Blvd
Ste 2
College Park, GA 30349-5552
Phone (770) 997-1738

Other identifiers 2

IdentifierTypeStateIssuer
000545201AMedicaidGA
000545201BMedicaidGA

Other names 1

  • Assessment and Counseling Services Doing business as

National Provider Directory

National Provider Directory

Locations

1651 Phoenix Blvd
Ste 2
College Park, GA 30349
Phone (770) 997-1738

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1253232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353974400000",
    "number": "1093048324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1651 PHOENIX BLVD",
            "address_2": "STE 2",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303495552",
            "telephone_number": "770-997-1738",
            "fax_number": "770-991-1375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 PHOENIX BLVD STE 2",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303495552",
            "telephone_number": "770-997-1738",
            "fax_number": "770-991-1375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN SNOOK, PH.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-18",
        "last_updated": "2012-11-27",
        "status": "A",
        "authorized_official_last_name": "SROKA",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "770-997-1738"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC003891",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC0006197",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY0001477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000545201A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000545201B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Assessment and Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in College Park, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.