Provider Demographics
NPI:1376956540
Name:SNYDER, NICOLE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:
Last Name:SNYDER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BROWN AVE
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:WV
Mailing Address - Zip Code:26452-2177
Mailing Address - Country:US
Mailing Address - Phone:304-269-3923
Mailing Address - Fax:304-269-9733
Practice Address - Street 1:351 E. MAIN ST.
Practice Address - Street 2:SUITE 101
Practice Address - City:BRIDGEPORT
Practice Address - State:WV
Practice Address - Zip Code:26330-1845
Practice Address - Country:US
Practice Address - Phone:303-848-0303
Practice Address - Fax:304-269-9733
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2131101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor