Provider Demographics
NPI:1023429305
Name:SNOW, JEAN (LCPC)
Entity type:Individual
Prefix:MS
First Name:JEAN
Middle Name:
Last Name:SNOW
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121-123 WEST MAIN STREET
Mailing Address - Street 2:C/O EMMITSBURG OSTEOPATHIC PRIMARY CARE CENTER
Mailing Address - City:EMMITSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21727
Mailing Address - Country:US
Mailing Address - Phone:202-280-0797
Mailing Address - Fax:
Practice Address - Street 1:44 N POTOMAC ST
Practice Address - Street 2:SUITE 204
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-4855
Practice Address - Country:US
Practice Address - Phone:202-280-0797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-08
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4363101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional