Healthcare Provider Details

I. General information

NPI: 1740104595
Provider Name (Legal Business Name): TALAYA NYEEMA BRYANT LGPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

9301 ANNAPOLIS RD
LANHAM MD
20706-3115
US

IV. Provider business mailing address

6601 GREIG ST
SEAT PLEASANT MD
20743-1758
US

V. Phone/Fax

Practice location:
  • Phone: 240-296-6300
  • Fax: 301-263-7299
Mailing address:
  • Phone: 240-579-8174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGP17990
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGP17990
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLGP17990
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: