Healthcare Provider Details

I. General information

NPI: 1821975251
Provider Name (Legal Business Name): KATELYN SIERRA SNYDER MS, LPC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2025
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 MANCHESTER AVE
FLORENCE SC
29505-3130
US

IV. Provider business mailing address

706 MANCHESTER AVE
FLORENCE SC
29505-3130
US

V. Phone/Fax

Practice location:
  • Phone: 843-597-6816
  • Fax:
Mailing address:
  • Phone: 843-597-6816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number10474
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: