Provider Demographics
NPI:1699970285
Name:SNYDER-BARKER, MICHAEL JOHN (LMSW CAAC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOHN
Last Name:SNYDER-BARKER
Suffix:
Gender:M
Credentials:LMSW CAAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 S MAUMEE ST
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:MI
Mailing Address - Zip Code:49286-2004
Mailing Address - Country:US
Mailing Address - Phone:517-424-5438
Mailing Address - Fax:517-424-0918
Practice Address - Street 1:106 S MAUMEE ST
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:MI
Practice Address - Zip Code:49286-2004
Practice Address - Country:US
Practice Address - Phone:517-424-5438
Practice Address - Fax:517-424-0918
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-15
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1 00352101YA0400X
MI68010610601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)