Provider Demographics
NPI:1417357187
Name:SNOW, JAMES ALFRED (MED, LMHC, CAP)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ALFRED
Last Name:SNOW
Suffix:
Gender:M
Credentials:MED, LMHC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1477 E BEXLEY PARK DR
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-3543
Mailing Address - Country:US
Mailing Address - Phone:561-452-5610
Mailing Address - Fax:561-431-2961
Practice Address - Street 1:810 ANDREWS AVE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-7220
Practice Address - Country:US
Practice Address - Phone:561-452-5610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-29
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5537101YA0400X
FLMH13809101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH13809OtherLICENSED MENTAL HEALTH COUNSELOR
FL5537OtherFLORIDA CERTIFIED ADDICTIONS PROFESSIONAL