Basic Information
Provider Information
NPI: 1871661884
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SNAPPER
FirstName: IRIS
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2101 E JEFFERSON ST
Address2: KAISER PERMANENTE MEDICARE ENROLLMENT
City: ROCKVILLE
State: MD
PostalCode: 208524908
CountryCode: US
TelephoneNumber: 3018162424
FaxNumber:  
Practice Location
Address1: 10500 SUMMIT AVE
Address2: KAISER PERMANENTE BEHAVIORAL HEALTH CENTER
City: KENSINGTON
State: MD
PostalCode: 208952422
CountryCode: US
TelephoneNumber: 3018972500
FaxNumber: 3018972333
Other Information
ProviderEnumerationDate: 11/30/2006
LastUpdateDate: 06/03/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/03/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X05330MDY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


Home