Provider Demographics
NPI:1740466465
Name:LAYNE, MICHAEL ANTHONY (LCSW-C)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:LAYNE
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20 PLEASANT RIDGE DR STE E
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-2560
Mailing Address - Country:US
Mailing Address - Phone:443-544-7744
Mailing Address - Fax:443-870-3129
Practice Address - Street 1:20 PLEASANT RIDGE DR STE A
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-2560
Practice Address - Country:US
Practice Address - Phone:443-544-7744
Practice Address - Fax:443-870-3129
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-11
Last Update Date:2025-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD129531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4115422 00Medicaid