Provider Demographics
NPI:1417965666
Name:SNIFFEN, KRISTIE LYNN CAPELLO (LCSW)
Entity Type:Individual
Prefix:
First Name:KRISTIE
Middle Name:LYNN CAPELLO
Last Name:SNIFFEN
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 1:66 STONE ST.
Mailing Address - Street 2:KENNEBEC BEHAVIORAL HEALTH
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330
Mailing Address - Country:US
Mailing Address - Phone:207-626-3255
Mailing Address - Fax:
Practice Address - Street 1:66 STONE ST.
Practice Address - Street 2:KENNEBEC BEHAVIORAL HEALTH
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330
Practice Address - Country:US
Practice Address - Phone:207-626-3255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW76781041C0700X
MELC132801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical