Healthcare Provider Details

I. General information

NPI: 1215527684
Provider Name (Legal Business Name): MARYBETH SNYDER LGPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2021
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 RHODE ISLAND AVE NW
WASHINGTON DC
20001-4153
US

IV. Provider business mailing address

915 RHODE ISLAND AVE NW
WASHINGTON DC
20001-4153
US

V. Phone/Fax

Practice location:
  • Phone: 202-232-6100
  • Fax:
Mailing address:
  • Phone: 202-232-6100
  • Fax: 202-644-7024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGPC00658
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: