1215374111 NPI number — KRISTIN LEIGH SNYDER M.S.W. AND L.C.S.W.

NPI Number: 1215374111
Health Care Provider/Practitioner: KRISTIN LEIGH SNYDER M.S.W. AND L.C.S.W.

NPI Number : 1215374111 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1215374111",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SNYDER",
    "FirstName": "KRISTIN",
    "MiddleName": "LEIGH",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "M.S.W. AND L.C.S.W.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BORYS",
    "OtherFirstName": "KRISTIN",
    "OtherMiddleName": "LEIGH",
    "OtherNamePrefix": "MISS",
    "OtherNameSuffix": null,
    "OtherCredential": "(NOTE- MAIDEN NAME)",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "77 FRENCH ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SOMERSET",
    "MailingAddressStateName": "NJ",
    "MailingAddressPostalCode": "08873-2714",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "908-307-0697",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "18 NORTON RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "EAST BRUNSWICK",
    "PracticeLocationAddressStateName": "NJ",
    "PracticeLocationAddressPostalCode": "08816-1704",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "732-613-6800",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/31/2013",
    "LastUpdateDate": "10/23/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1041C0700X",
        "TaxonomyName": "Clinical Social Worker",
        "LicenseNumber": "44SCO5497400",
        "LicenseNumberStateCode": "NJ",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}