Individual provider Active NPI

Sandra B Snow, PH.D., LCSWC

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1245347913
Registry record updated Feb 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4741 Issued in MD
Practice address
3811 Canterbury Rd
Doctors Office
Baltimore, MD 21218-2340
Phone
(410) 889-9404
Fax
(410) 889-3616
NPI assigned
Aug 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4741 MD Primary

Addresses

Primary practice location

3811 Canterbury Rd
Doctors Office
Baltimore, MD 21218-2340

Mailing address

2 W 39TH St
Baltimore, MD 21218-1701
Phone (410) 889-9404

Other identifiers 2

IdentifierTypeStateIssuer
124461200MedicaidMD
41704703OtherMDCAREFIRST BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120126000230 MD Practitioner - Clinical Social Worker 6800063298 Practice locations: Baltimore, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1981
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3811 Canterbury Rd
Baltimore, MD 21218-2340
Phone (410) 889-9404

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
04741MDMDHealth Psychologist
4741MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Shevitz Psychiatric PastSince Aug 15, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487203200000",
    "number": "1245347913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 W 39TH ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212181701",
            "telephone_number": "410-889-9404",
            "fax_number": "410-889-3616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 CANTERBURY RD",
            "address_2": "DOCTORS OFFICE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212182340",
            "telephone_number": "410-889-9404",
            "fax_number": "410-889-3616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNOW",
        "first_name": "SANDRA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "PH.D., LCSWC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2017-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "4741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124461200",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "41704703",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.