Provider Demographics
NPI:1891977427
Name:SNEDEKER, JESSICA FAYE (MS, NCC, LPC-MH)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:FAYE
Last Name:SNEDEKER
Suffix:
Gender:F
Credentials:MS, NCC, LPC-MH
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:FAYE
Other - Last Name:LENZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC-MH, QMHP
Mailing Address - Street 1:2500 W 49TH ST STE 202
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-6559
Mailing Address - Country:US
Mailing Address - Phone:605-275-2030
Mailing Address - Fax:605-275-2031
Practice Address - Street 1:2500 W 49TH ST STE 202
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-6559
Practice Address - Country:US
Practice Address - Phone:605-275-2030
Practice Address - Fax:605-275-2031
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC1190101YM0800X
SDLPC-MH 2217101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health