Healthcare Provider Details

I. General information

NPI: 1962171512
Provider Name (Legal Business Name): ARIN CALLANEN JAYES LCPC, NCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2021
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 WASHINGTON AVE # 510
TOWSON MD
21204-4763
US

IV. Provider business mailing address

200 WASHINGTON AVE # 510
TOWSON MD
21204-4763
US

V. Phone/Fax

Practice location:
  • Phone: 202-380-6519
  • Fax:
Mailing address:
  • Phone: 202-380-6519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGP11659
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: