Healthcare Provider Details

I. General information

NPI: 1336992494
Provider Name (Legal Business Name): THOMAS SNYDER LCPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2024
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 S FREDERICK AVE STE 200
GAITHERSBURG MD
20877-4152
US

IV. Provider business mailing address

800 S FREDERICK AVE STE 200
GAITHERSBURG MD
20877-4152
US

V. Phone/Fax

Practice location:
  • Phone: 443-212-8350
  • Fax:
Mailing address:
  • Phone: 443-212-8350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC17725
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC17725
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: