Provider Demographics
NPI:1497770614
Name:SNYDER, LEAH M (LCSW-R)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:M
Last Name:SNYDER
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 GARY LN
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14227-3265
Mailing Address - Country:US
Mailing Address - Phone:716-656-7252
Mailing Address - Fax:
Practice Address - Street 1:70 BARKER ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14209-2013
Practice Address - Country:US
Practice Address - Phone:716-883-1914
Practice Address - Fax:716-883-7637
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0508671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000526539001OtherBC/BS WNY
NY00025753501OtherUNIVERA
NY00688211Medicaid
NYP29562Medicare UPIN