Provider Demographics
NPI:1043959240
Name:SNOWDEN, BRIAH (LMSW, BS)
Entity Type:Individual
Prefix:MS
First Name:BRIAH
Middle Name:
Last Name:SNOWDEN
Suffix:
Gender:F
Credentials:LMSW, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 PINE ST APT 614
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63103-2373
Mailing Address - Country:US
Mailing Address - Phone:314-240-2104
Mailing Address - Fax:
Practice Address - Street 1:2151 W 79TH ST STE 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60620-5723
Practice Address - Country:US
Practice Address - Phone:312-757-0608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-03
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.107527104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker