Provider Demographics
NPI:1972750388
Name:SNIVELY, JILL DWAINETTE (MDIV, MS, LPC)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:DWAINETTE
Last Name:SNIVELY
Suffix:
Gender:F
Credentials:MDIV, MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2633 LOCHBUIE CIR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-5385
Mailing Address - Country:US
Mailing Address - Phone:610-334-5595
Mailing Address - Fax:610-300-7759
Practice Address - Street 1:2633 LOCHBUIE CIR
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-5385
Practice Address - Country:US
Practice Address - Phone:610-334-5595
Practice Address - Fax:610-300-7759
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-27
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005092101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional