Organization
AUTHENTIC SPACES COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAUREN ANN BYNUM PHD (OWNER/CLINICAL PSYCHOLOGIST)
(773) 301-3730
Entity
Organization
Contact information
Practice address
4502 SCHENLEY RD # 100A, BALTIMORE, MD 21210-2524
(443) 440-6125
Mailing address
5113 FALLS ROAD TER, BALTIMORE, MD 21210-1921
(773) 301-3730
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
05089
MD
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
06/04/2018
Last updated
04/25/2019
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