Healthcare Provider Details

I. General information

NPI: 1730997032
Provider Name (Legal Business Name): SNIDERMAN COUNSELING CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2024
Last Update Date: 12/19/2024
Certification Date: 12/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2044 W HADDON AVE APT 2
CHICAGO IL
60622-4140
US

IV. Provider business mailing address

2044 W HADDON AVE APT 2
CHICAGO IL
60622-4140
US

V. Phone/Fax

Practice location:
  • Phone: 773-991-3722
  • Fax:
Mailing address:
  • Phone: 773-991-3722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: SUSAN SNIDERMAN
Title or Position: FOUNDER/CLINICIAN
Credential: LCSW
Phone: 773-991-3722