Provider Demographics
NPI:1578202412
Name:PRICE, LEN JR (LCSW-C, LCADC)
Entity Type:Individual
Prefix:MR
First Name:LEN
Middle Name:
Last Name:PRICE
Suffix:JR
Gender:M
Credentials:LCSW-C, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1216 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21213-3017
Mailing Address - Country:US
Mailing Address - Phone:443-848-1849
Mailing Address - Fax:
Practice Address - Street 1:1216 N BROADWAY
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-3017
Practice Address - Country:US
Practice Address - Phone:443-848-1849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-31
Last Update Date:2023-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCA2794101YA0400X
MD234251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)