Provider Demographics
NPI:1295782027
Name:SNYDER, CARA E (MSW/LISW)
Entity type:Individual
Prefix:MS
First Name:CARA
Middle Name:E
Last Name:SNYDER
Suffix:
Gender:F
Credentials:MSW/LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:775 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44907-1906
Mailing Address - Country:US
Mailing Address - Phone:419-774-4010
Mailing Address - Fax:419-774-4014
Practice Address - Street 1:775 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-1906
Practice Address - Country:US
Practice Address - Phone:419-774-4010
Practice Address - Fax:419-774-4014
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-313091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSESW30131Medicare PIN