Healthcare Provider Details

I. General information

NPI: 1548781834
Provider Name (Legal Business Name): ALLEN SNYDER LCSW-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2017
Last Update Date: 02/18/2020
Certification Date: 02/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 W WASHINGTON ST # 228
HAGERSTOWN MD
21740-4734
US

IV. Provider business mailing address

PO BOX 973
WESTMINSTER MD
21158-0973
US

V. Phone/Fax

Practice location:
  • Phone: 540-999-8418
  • Fax:
Mailing address:
  • Phone: 410-848-5785
  • Fax: 410-848-5629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number19068
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: