Individual
MR. MATTHEW RAYMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1495 CHAIN BRIDGE RD STE 300, MC LEAN, VA 22101-5727
(703) 598-5559
Mailing address
1495 CHAIN BRIDGE RD STE 300, MC LEAN, VA 22101-5727
(202) 262-2010
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0904013251
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0904013251
NON-MEDICARE
VA
Enumeration date
04/26/2022
Last updated
04/26/2022
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