Provider Demographics
NPI:1700050341
Name:SNOGREN, SKY (MA, LPC LPCC)
Entity Type:Individual
Prefix:
First Name:SKY
Middle Name:
Last Name:SNOGREN
Suffix:
Gender:M
Credentials:MA, LPC LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:488 CANDY KITCHEN RD
Mailing Address - Street 2:HC61 BOX 4031
Mailing Address - City:RAMAH
Mailing Address - State:NM
Mailing Address - Zip Code:87321-2851
Mailing Address - Country:US
Mailing Address - Phone:541-301-5669
Mailing Address - Fax:
Practice Address - Street 1:488 CANDY KITCHEN RD
Practice Address - Street 2:
Practice Address - City:RAMAH
Practice Address - State:NM
Practice Address - Zip Code:87321-2851
Practice Address - Country:US
Practice Address - Phone:541-301-5669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-15
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5315101YP2500X
ORC4136101YP2500X
NMCTB-2023-0496101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional