Healthcare Provider Details

I. General information

NPI: 1952715021
Provider Name (Legal Business Name): CRISTINA SNIPES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2014
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 E 12TH AVE
NAPERVILLE IL
60563-2713
US

IV. Provider business mailing address

209 E 12TH AVE
NAPERVILLE IL
60563-2713
US

V. Phone/Fax

Practice location:
  • Phone: 919-928-5577
  • Fax:
Mailing address:
  • Phone: 919-928-5577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC008882
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.014754
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: