Provider Demographics
NPI:1730240375
Name:SNOW, SHARMAN KAY (LCSW)
Entity type:Individual
Prefix:MS
First Name:SHARMAN
Middle Name:KAY
Last Name:SNOW
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 N 1ST E
Mailing Address - Street 2:
Mailing Address - City:SODA SPRINGS
Mailing Address - State:ID
Mailing Address - Zip Code:83276-1203
Mailing Address - Country:US
Mailing Address - Phone:208-547-4888
Mailing Address - Fax:
Practice Address - Street 1:160 N 1ST E
Practice Address - Street 2:
Practice Address - City:SODA SPRINGS
Practice Address - State:ID
Practice Address - Zip Code:83276-1203
Practice Address - Country:US
Practice Address - Phone:208-547-4888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-8631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical