Provider Demographics
NPI:1619383346
Name:SNYDER, LISA (LMHC, CASAC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:SNYDER
Suffix:
Gender:F
Credentials:LMHC, CASAC
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:LAGATTUTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC, CASAC
Mailing Address - Street 1:8 GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-1357
Mailing Address - Country:US
Mailing Address - Phone:845-332-4311
Mailing Address - Fax:845-795-6279
Practice Address - Street 1:8 GARDEN ST
Practice Address - Street 2:
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-1357
Practice Address - Country:US
Practice Address - Phone:845-332-4311
Practice Address - Fax:845-795-6279
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-02
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006053101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health