Healthcare Provider Details

I. General information

NPI: 1659821270
Provider Name (Legal Business Name): NICOLE M. SNYDER MS, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2016
Last Update Date: 11/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4633 AICHOLTZ ROAD
CINCINNATI OH
45244
US

IV. Provider business mailing address

4629 AICHOLTZ ROAD
CINCINNATI OH
45244-1518
US

V. Phone/Fax

Practice location:
  • Phone: 513-752-1555
  • Fax:
Mailing address:
  • Phone: 513-752-1555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.1400514
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.1800960
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: