Healthcare Provider Details

I. General information

NPI: 1104642073
Provider Name (Legal Business Name): RYLEE MARIE POWERS LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2024
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2912 WALNUT AVE
OWINGS MILLS MD
21117-1524
US

IV. Provider business mailing address

2912 WALNUT AVE
OWINGS MILLS MD
21117-1524
US

V. Phone/Fax

Practice location:
  • Phone: 410-870-7724
  • Fax:
Mailing address:
  • Phone: 410-870-7724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPC000983
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC18036
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: