Provider Demographics
NPI:1245902311
Name:SNYDER, MARY E (LCSW)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:SNYDER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 EAST ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:PA
Mailing Address - Zip Code:16365-2504
Mailing Address - Country:US
Mailing Address - Phone:814-688-3806
Mailing Address - Fax:
Practice Address - Street 1:1521 CEDAR CLIFF DR STE 200
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-7706
Practice Address - Country:US
Practice Address - Phone:484-509-1079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-28
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0247601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical