Healthcare Provider Details

I. General information

NPI: 1033427885
Provider Name (Legal Business Name): DENISE LYNNE SNYDER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2010
Last Update Date: 09/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 WATERVLIET SHAKER RD
ALBANY NY
12205-1002
US

IV. Provider business mailing address

504 VICTORY CIR
BALLSTON SPA NY
12020-2306
US

V. Phone/Fax

Practice location:
  • Phone: 518-862-4920
  • Fax:
Mailing address:
  • Phone: 518-885-3290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberR046394-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: