Provider Demographics
NPI:1679610430
Name:THE SNYVANS GROUP
Entity Type:Organization
Organization Name:THE SNYVANS GROUP
Other - Org Name:A CENTER FOR HUMAN POTENTIAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:727-669-5707
Mailing Address - Street 1:670 2ND ST N
Mailing Address - Street 2:SUITE D
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-3563
Mailing Address - Country:US
Mailing Address - Phone:727-669-5707
Mailing Address - Fax:727-669-5733
Practice Address - Street 1:670 2ND ST N
Practice Address - Street 2:SUITE D
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-3563
Practice Address - Country:US
Practice Address - Phone:727-669-5707
Practice Address - Fax:727-669-5733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSS361103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty