Healthcare Provider Details

I. General information

NPI: 1902562614
Provider Name (Legal Business Name): BYRAN LEE LCMFT, LCADC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2021
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3730 FALLS RD
BALTIMORE MD
21211-1844
US

IV. Provider business mailing address

2530 MARYLAND AVE APT 2F
BALTIMORE MD
21218-4546
US

V. Phone/Fax

Practice location:
  • Phone: 410-204-1983
  • Fax:
Mailing address:
  • Phone: 443-602-5373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLCM1222
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCA3126
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: