Provider Demographics
NPI:1801621354
Name:RAEL, MATTHEW (LCSW)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:
Last Name:RAEL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 BULLDOG BLVD
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:NM
Mailing Address - Zip Code:88210-1899
Mailing Address - Country:US
Mailing Address - Phone:575-626-9101
Mailing Address - Fax:575-746-6232
Practice Address - Street 1:1806 CENTRE AVE.
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:NM
Practice Address - Zip Code:88210
Practice Address - Country:US
Practice Address - Phone:575-626-9101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-04
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical