Provider Demographics
NPI:1154518702
Name:SCHNEIDER, MATTHEW DAVID EDWARD (LCSW-C)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:DAVID EDWARD
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 67
Mailing Address - Street 2:
Mailing Address - City:RAILROAD
Mailing Address - State:PA
Mailing Address - Zip Code:17355-0067
Mailing Address - Country:US
Mailing Address - Phone:410-507-6630
Mailing Address - Fax:
Practice Address - Street 1:27 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:PA
Practice Address - Zip Code:17361-1321
Practice Address - Country:US
Practice Address - Phone:410-507-6630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD156691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD522156095OtherCOMMERCIAL
MD522156095OtherMHNET
MD522156095OtherAMERICAN PSYCH SYSTEM
MD609550002Medicaid
MD522156095OtherCOMMERCIAL