Healthcare Provider Details

I. General information

NPI: 1417582073
Provider Name (Legal Business Name): ENYAL FAMILY THERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2020
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 PLEASANT RIDGE DR STE A
OWINGS MILLS MD
21117-2560
US

IV. Provider business mailing address

20 PLEASANT RIDGE DR STE A
OWINGS MILLS MD
21117-2560
US

V. Phone/Fax

Practice location:
  • Phone: 443-544-7744
  • Fax: 443-870-3129
Mailing address:
  • Phone: 443-544-7744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL ANTHONY LAYNE
Title or Position: OWNER/PROGRAM DIRECTOR
Credential: LCSW-C
Phone: 443-544-7744