Provider Demographics
NPI:1104975820
Name:JAMES L. SNELL PHD LMFT
Entity type:Organization
Organization Name:JAMES L. SNELL PHD LMFT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:LANE
Authorized Official - Last Name:SNELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD LMFT
Authorized Official - Phone:530-257-4404
Mailing Address - Street 1:PO BOX 401
Mailing Address - Street 2:617 MAIN STREET SUITES 202 203
Mailing Address - City:SUSANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:96130-0401
Mailing Address - Country:US
Mailing Address - Phone:530-257-4404
Mailing Address - Fax:530-257-4404
Practice Address - Street 1:617 MAIN STREET
Practice Address - Street 2:SUITES 202 203
Practice Address - City:SUSANVILLE
Practice Address - State:CA
Practice Address - Zip Code:96130-0401
Practice Address - Country:US
Practice Address - Phone:530-257-4404
Practice Address - Fax:530-257-4404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 40369106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1194886945Medicare UPIN