Healthcare Provider Details

I. General information

NPI: 1346424215
Provider Name (Legal Business Name): LENETTE GIMPLE SNYDER LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2007
Last Update Date: 12/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10605 CONCORD ST SUITE 100
KENSINGTON MD
20895-2504
US

IV. Provider business mailing address

5905 WELBORN DR
BETHESDA MD
20816-3423
US

V. Phone/Fax

Practice location:
  • Phone: 301-807-8116
  • Fax:
Mailing address:
  • Phone: 301-320-3135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC2132
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: