Provider Demographics
NPI:1003042755
Name:SNYDER-LINDBLOM, MELANIE BARBARA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:BARBARA
Last Name:SNYDER-LINDBLOM
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:MELANIE
Other - Middle Name:BARBARA
Other - Last Name:SNYDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSW
Mailing Address - Street 1:520 WELLESLEY ST
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-1519
Mailing Address - Country:US
Mailing Address - Phone:248-644-1629
Mailing Address - Fax:
Practice Address - Street 1:300 W HURON ST
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-1420
Practice Address - Country:US
Practice Address - Phone:248-451-7147
Practice Address - Fax:248-334-1164
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801015739104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0892585OtherBC/BS