Healthcare Provider Details

I. General information

NPI: 1477182061
Provider Name (Legal Business Name): SEAN EDWARD SNYDER LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2020
Last Update Date: 08/04/2023
Certification Date: 08/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 SOUTH 8TH STREET
PHILADELPHIA PA
19106
US

IV. Provider business mailing address

245 SOUTH 8TH STREET
PHILADELPHIA PA
19106
US

V. Phone/Fax

Practice location:
  • Phone: 215-829-5383
  • Fax:
Mailing address:
  • Phone: 610-945-7337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW019998
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: