Provider Demographics
NPI:1194834150
Name:SNIPES, ERNEST NEIL (LCSW)
Entity Type:Individual
Prefix:
First Name:ERNEST
Middle Name:NEIL
Last Name:SNIPES
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 E BEAUREGARD AVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76903-5831
Mailing Address - Country:US
Mailing Address - Phone:325-655-9390
Mailing Address - Fax:325-655-9390
Practice Address - Street 1:16 E BEAUREGARD AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903-5831
Practice Address - Country:US
Practice Address - Phone:325-655-9390
Practice Address - Fax:325-655-9390
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX248571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00595EMedicare ID - Type Unspecified