Provider Demographics
NPI:1558901850
Name:SNEAD, JESSE BRYAN (MA, NCC, LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:JESSE
Middle Name:BRYAN
Last Name:SNEAD
Suffix:
Gender:M
Credentials:MA, NCC, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 N QUINLAN PARK RD STE 240-301
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78732-6083
Mailing Address - Country:US
Mailing Address - Phone:512-850-6019
Mailing Address - Fax:
Practice Address - Street 1:2900 N QUINLAN PARK RD STE 240-301
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78732-6083
Practice Address - Country:US
Practice Address - Phone:512-850-6019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-14
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203213106H00000X
TX79762101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist