Provider Demographics
NPI:1497210801
Name:SNYDER, SHANNON R (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:R
Last Name:SNYDER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:R
Other - Last Name:EVENER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:115 ANDREW CT
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17015-4371
Mailing Address - Country:US
Mailing Address - Phone:717-385-0785
Mailing Address - Fax:
Practice Address - Street 1:115 ANDREW CT
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17015-4371
Practice Address - Country:US
Practice Address - Phone:717-385-0785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011085101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health