Healthcare Provider Details

I. General information

NPI: 1467580944
Provider Name (Legal Business Name): SHERRY A SNYDER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHERRY A SCHRADER

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3125 POPLARWOOD CT ASPEN BLDG, SUITE 100
RALEIGH NC
27604-1084
US

IV. Provider business mailing address

PO BOX 10414 C O PARADIGM HEALTH SERVICES
LARGO FL
33773-0414
US

V. Phone/Fax

Practice location:
  • Phone: 800-632-6074
  • Fax: 866-341-7509
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC004813
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: