Provider Demographics
NPI:1538530118
Name:SNYDER, THOMAS EDDIE JR (LCSW)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:EDDIE
Last Name:SNYDER
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2145 REVEREND RICHARD WILSON DR
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70062-7661
Mailing Address - Country:US
Mailing Address - Phone:504-472-0068
Mailing Address - Fax:504-472-0078
Practice Address - Street 1:2145 REVEREND RICHARD WILSON DR
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70062-7661
Practice Address - Country:US
Practice Address - Phone:504-472-0068
Practice Address - Fax:504-472-0078
Is Sole Proprietor?:No
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA54591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical