Healthcare Provider Details

I. General information

NPI: 1811047806
Provider Name (Legal Business Name): JEANNE MARIE SNARICH LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 09/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 ELM ST
BATAVIA IL
60510-2566
US

IV. Provider business mailing address

218 ELM ST
BATAVIA IL
60510-2566
US

V. Phone/Fax

Practice location:
  • Phone: 847-306-0715
  • Fax: 630-761-8339
Mailing address:
  • Phone: 847-306-0715
  • Fax: 630-761-8339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.010446
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number2140953
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: