Provider Demographics
NPI:1104800150
Name:SNOWDEN, JAMES V (PH D)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:V
Last Name:SNOWDEN
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 DOUGLAS ST STE 504
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51101-1471
Mailing Address - Country:US
Mailing Address - Phone:712-258-1000
Mailing Address - Fax:712-252-1100
Practice Address - Street 1:401 DOUGLAS STREET
Practice Address - Street 2:SUITE 504
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51101-1471
Practice Address - Country:US
Practice Address - Phone:712-258-1000
Practice Address - Fax:712-252-1100
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-02
Last Update Date:2021-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00565103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0417956Medicaid
W02735Medicare UPIN
IA0417956Medicaid