Provider Demographics
NPI:1578658357
Name:RAEDER, MATTHEW FRANCIS (MSW, LGSW)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:FRANCIS
Last Name:RAEDER
Suffix:
Gender:M
Credentials:MSW, LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1896 ALBAN CT
Mailing Address - Street 2:
Mailing Address - City:SEVERN
Mailing Address - State:MD
Mailing Address - Zip Code:21144-1567
Mailing Address - Country:US
Mailing Address - Phone:301-596-0391
Mailing Address - Fax:
Practice Address - Street 1:8187 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:SEVERN
Practice Address - State:MD
Practice Address - Zip Code:21144-3205
Practice Address - Country:US
Practice Address - Phone:410-882-1988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDG04647104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker