Ellen Williams Snipes, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

PY3865 Issued in FL

Practice address

10 Clark St
Enterprise, FL 32725-8106

Phone

(386) 668-9407

NPI assigned

May 30, 2008

Last updated

May 30, 2008By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212105600000",
    "number": "1982862520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CLARK ST",
            "city": "ENTERPRISE",
            "state": "FL",
            "postal_code": "327258106",
            "telephone_number": "386-668-9407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CLARK ST",
            "city": "ENTERPRISE",
            "state": "FL",
            "postal_code": "327258106",
            "telephone_number": "386-668-9407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNIPES",
        "first_name": "ELLEN",
        "middle_name": "WILLIAMS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-30",
        "last_updated": "2008-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "FL",
            "license": "PY3865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211234500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF FLORIDA",
            "identifier": "73168",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Counseling Psychologist in Enterprise, FL
• Providers in Enterprise, FL by specialty
• Counseling Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2008; 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.