Individual provider Active NPI

Donna M Snyder, LCSW, CAC DIPLOMATE

  • Clinical Social Worker
  • Erie, PA
National Provider Identifier
1053410779
Registry record updated Jun 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW013311 Issued in PA
Practice address
1910 Sassafras St
Suite 100
Erie, PA 16502-2716
Phone
(814) 452-5490
Fax
(814) 452-7610
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW013311 PA Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 4586 CAC DIPLOMATE PA

Addresses

Primary practice location

1910 Sassafras St
Suite 100
Erie, PA 16502-2716

Mailing address

12635 Plank Rd
Waterford, PA 16441-9023
Phone (814) 860-5036

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4586 CAC DIPLOMATEPAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Vincent Medical Education and Research Institute Past Accepting new patients
Abcs of Building Better Lives LLC PastSince Sep 1, 2012 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275955200000",
    "number": "1053410779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12635 PLANK RD",
            "city": "WATERFORD",
            "state": "PA",
            "postal_code": "164419023",
            "telephone_number": "814-860-5036",
            "fax_number": "814-860-5063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 SASSAFRAS ST",
            "address_2": "SUITE 100",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022716",
            "telephone_number": "814-452-5490",
            "fax_number": "814-452-7610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "DONNA",
        "middle_name": "M",
        "credential": "LCSW, CAC DIPLOMATE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2010-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW013311",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "PA",
            "license": "4586 CAC DIPLOMATE",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.