Colene A. Snowden, AFC PROVIDER

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

AF630004934 Issued in MI

Practice address

18331 Tipsico Lake Rd
Fenton, MI 48430-8554

Phone

(810) 629-0251

Fax

(810) 629-0251

NPI assigned

May 25, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1495670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495670400000",
    "number": "1780112383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18331 TIPSICO LAKE RD",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484308554",
            "telephone_number": "810-629-0251",
            "fax_number": "810-629-0251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18331 TIPSICO LAKE RD",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484308554",
            "telephone_number": "810-629-0251",
            "fax_number": "810-629-0251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNOWDEN",
        "first_name": "COLENE",
        "middle_name": "A.",
        "name_prefix": "Mrs.",
        "credential": "AFC PROVIDER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-25",
        "last_updated": "2017-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "MI",
            "license": "AF630004934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Idalis Slotka, LLMSW
• Mitchell Jason Smelis, ATC
• Rachael Smith, PA-C
• Ryan Noelle Smith
• Shelby Lynn Beckman Smith, LPC, NCC
• McKenzie Sobczak, TLLP
• Sonoma Dental Group, P.C.
• Sonoma Dental Group, P.C.
• Spark Speech Therapy LLC
• SSC Fenton Operating Company LLC

• Intellectual Disabilities Intermediate Care Facility in Fenton, MI
• Providers in Fenton, MI by specialty
• Intellectual Disabilities Intermediate Care Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2017; 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.