Provider Demographics
NPI:1619103330
Name:SNIDER, MICHAEL B (LPC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:B
Last Name:SNIDER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 WATER ST APT P2
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-5257
Mailing Address - Country:US
Mailing Address - Phone:830-777-0172
Mailing Address - Fax:
Practice Address - Street 1:550 EARL GARRETT ST STE 207B
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-4577
Practice Address - Country:US
Practice Address - Phone:830-955-8220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16303101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor