Provider Demographics
NPI:1407943731
Name:BYRLEY, MARY B (LPCC)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:B
Last Name:BYRLEY
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6230 BUSCH BLVD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-1826
Mailing Address - Country:US
Mailing Address - Phone:614-885-2431
Mailing Address - Fax:614-885-6188
Practice Address - Street 1:6230 BUSCH BLVD
Practice Address - Street 2:SUITE 310
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-1826
Practice Address - Country:US
Practice Address - Phone:614-885-2431
Practice Address - Fax:614-885-6188
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE-1776101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH22594400OtherMAGELLAN
OH000000315455OtherANTHEM