Provider Demographics
NPI:1053410779
Name:SNYDER, DONNA M (LCSW, CAC DIPLOMATE)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:SNYDER
Suffix:
Gender:F
Credentials:LCSW, CAC DIPLOMATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12635 PLANK RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:PA
Mailing Address - Zip Code:16441-9023
Mailing Address - Country:US
Mailing Address - Phone:814-860-5036
Mailing Address - Fax:814-860-5063
Practice Address - Street 1:1910 SASSAFRAS ST
Practice Address - Street 2:SUITE 100
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-2716
Practice Address - Country:US
Practice Address - Phone:814-452-5490
Practice Address - Fax:814-452-7610
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0133111041C0700X
PA4586 CAC DIPLOMATE101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)