Provider Demographics
NPI:1174791354
Name:FISHLEDER, MATTHEW ELLIOTT (LCMFT, LMFT)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:ELLIOTT
Last Name:FISHLEDER
Suffix:
Gender:M
Credentials:LCMFT, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13606 AUTUMN TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-2955
Mailing Address - Country:US
Mailing Address - Phone:301-453-2527
Mailing Address - Fax:
Practice Address - Street 1:13606 AUTUMN TRAIL DR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-2955
Practice Address - Country:US
Practice Address - Phone:301-453-2527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-11
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100802106H00000X
MDLCM850106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist