Healthcare Provider Details

I. General information

NPI: 1336059518
Provider Name (Legal Business Name): JENNIFER L BAYERLE M.S., LGMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3905 NATIONAL DR STE 330
BURTONSVILLE MD
20866-6114
US

IV. Provider business mailing address

3948 NEMO RD
RANDALLSTOWN MD
21133-4042
US

V. Phone/Fax

Practice location:
  • Phone: 301-793-3997
  • Fax:
Mailing address:
  • Phone: 678-643-3028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLGM1215
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: