Provider Demographics
NPI:1376916239
Name:SNEED, TAJA (BS)
Entity Type:Individual
Prefix:MS
First Name:TAJA
Middle Name:
Last Name:SNEED
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3919 S 3RD ST APT 2
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40214-1601
Mailing Address - Country:US
Mailing Address - Phone:502-530-6872
Mailing Address - Fax:
Practice Address - Street 1:3919 S 3RD ST APT 2
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40214-1601
Practice Address - Country:US
Practice Address - Phone:502-530-6872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-01
Last Update Date:2018-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY251B00000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No101Y00000XBehavioral Health & Social Service ProvidersCounselor