Healthcare Provider Details

I. General information

NPI: 1669212783
Provider Name (Legal Business Name): MEGAN JUNE BOYLAN LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2024
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 LOCH RAVEN BLVD STE 103
BALTIMORE MD
21239-2950
US

IV. Provider business mailing address

4C NORTH AVE STE 432
BEL AIR MD
21014-2330
US

V. Phone/Fax

Practice location:
  • Phone: 443-444-6420
  • Fax: 443-444-3998
Mailing address:
  • Phone: 410-929-2687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number30070
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: