Provider Demographics
NPI:1780834606
Name:BIRD, LYNNDA R (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:LYNNDA
Middle Name:R
Last Name:BIRD
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7046 BRENTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MARRIOTTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21104-1048
Mailing Address - Country:US
Mailing Address - Phone:410-259-1125
Mailing Address - Fax:
Practice Address - Street 1:11301 LIBERTY RD
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4605
Practice Address - Country:US
Practice Address - Phone:410-882-1988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-28
Last Update Date:2008-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2333101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional