Healthcare Provider Details

I. General information

NPI: 1467103887
Provider Name (Legal Business Name): LYRIC SEYMORE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2022
Last Update Date: 01/18/2022
Certification Date: 01/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4623 FALLS RD
BALTIMORE MD
21209-4914
US

IV. Provider business mailing address

10 N CALVERT ST UNIT 515
BALTIMORE MD
21202-3324
US

V. Phone/Fax

Practice location:
  • Phone: 410-366-1980
  • Fax:
Mailing address:
  • Phone: 732-429-8091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number27511
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number27511
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: