Healthcare Provider Details

I. General information

NPI: 1477491678
Provider Name (Legal Business Name): BRYANT MICHAEL STONE PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12410 MILESTONE CENTER DR STE 600
GERMANTOWN MD
20876-7102
US

IV. Provider business mailing address

12050 LITTLE PATUXENT PKWY APT E
COLUMBIA MD
21044-4822
US

V. Phone/Fax

Practice location:
  • Phone: 301-245-2705
  • Fax:
Mailing address:
  • Phone: 330-888-9644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number07258
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: