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NPI Code Detail

MEDICARE: KAYLA A MANGEN LCPC

MEDICARE: KAYLA A MANGEN LCPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorLC6369MD

General Provider Information

NPI Number : 1659759017
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA A MANGEN LCPC
Provider Business Mailing Address
First Line : 1040 PARK AVE
Second Line : SUITE 103
City : BALTIMORE
State : MD
Zip : 21201-5633
Country : US
Telephone Number : 410-837-3977
Fax Number : 410-752-4218
Provider Business Practice Location Address
First Line : 800 INGLESIDE AVE
Second Line :
City : CATONSVILLE
State : MD
Zip : 21228-1722
Country : US
Telephone Number : 410-744-5937
Fax Number : 410-744-4674
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2015
Last Update Date : 05/26/2026

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Directions to “ KAYLA A MANGEN LCPC” Practice Location

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