Provider Demographics
NPI:1861722795
Name:RADER, L MARIA (LICSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:L MARIA
Middle Name:
Last Name:RADER
Suffix:
Gender:F
Credentials:LICSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 JUNCTION RD
Mailing Address - Street 2:
Mailing Address - City:WESTPORT ISLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04578-3409
Mailing Address - Country:US
Mailing Address - Phone:207-200-7168
Mailing Address - Fax:
Practice Address - Street 1:54 CUMBERLAND ST STE 5
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-1829
Practice Address - Country:US
Practice Address - Phone:207-200-7168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-26
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0001221531041C0700X
MELC217741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical