Provider Demographics
NPI:1437850229
Name:SNYDERMAN, EDITH ELIN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:EDITH
Middle Name:ELIN
Last Name:SNYDERMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 LINCOLN STREET, FIRST FLOOR
Mailing Address - Street 2:15 LINCOLN STREET, FIRST FLOOR
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-0241
Mailing Address - Country:US
Mailing Address - Phone:203-912-0993
Mailing Address - Fax:
Practice Address - Street 1:7 KENOSIA AVE
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-7395
Practice Address - Country:US
Practice Address - Phone:475-329-2686
Practice Address - Fax:203-456-3161
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-17
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0067811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty