Provider Demographics
NPI:1639471063
Name:TRADER, SUMMER BLEYER (LGSW)
Entity Type:Individual
Prefix:
First Name:SUMMER
Middle Name:BLEYER
Last Name:TRADER
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:SUMMER
Other - Middle Name:CAROL
Other - Last Name:BLEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LGSW
Mailing Address - Street 1:6224 FOOKS MILL RD
Mailing Address - Street 2:
Mailing Address - City:RHODESDALE
Mailing Address - State:MD
Mailing Address - Zip Code:21659-1160
Mailing Address - Country:US
Mailing Address - Phone:443-521-4810
Mailing Address - Fax:
Practice Address - Street 1:25390 RICHARDSON RD
Practice Address - Street 2:
Practice Address - City:FEDERALSBURG
Practice Address - State:MD
Practice Address - Zip Code:21632-2403
Practice Address - Country:US
Practice Address - Phone:410-754-9922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-17
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16534104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker