Provider Demographics
NPI:1871665349
Name:SNYDER, LYNN ADELE (MSW)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:ADELE
Last Name:SNYDER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8270 BURNT STORE RD UNIT 3
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950-4705
Mailing Address - Country:US
Mailing Address - Phone:941-505-8080
Mailing Address - Fax:941-505-8090
Practice Address - Street 1:8270 BURNT STORE RD UNIT 3
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-4705
Practice Address - Country:US
Practice Address - Phone:941-505-8080
Practice Address - Fax:941-505-8090
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 116561041C0700X
FL6018101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSNSW23094Medicare ID - Type Unspecified