NPIMap

Organization Active NPI

Authentic Spaces Counseling, LLC

  • Community/Behavioral Health Agency
  • Baltimore, MD
National Provider Identifier
1710479845
Registry record updated Apr 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
05089 Issued in MD
Legal business name
AUTHENTIC SPACES COUNSELING, LLC
Practice address
4502 Schenley Rd # 100a
Baltimore, MD 21210-2524
Phone
(443) 440-6125
NPI assigned
Jun 4, 2018
Last updated
Apr 25, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Lauren Ann Bynum, PHDNPI 1457530438
Title
Owner/Clinical Psychologist
Phone
(773) 301-3730

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 05089 MD Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

4502 Schenley Rd # 100a
Baltimore, MD 21210-2524

Mailing address

5113 Falls Road Ter
Baltimore, MD 21210-1921
Phone (773) 301-3730

Other practice location 1

5113 Falls Road Ter
Baltimore, MD 21210-1921
Phone (773) 301-3730

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556150400000",
    "number": "1710479845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5113 FALLS ROAD TER",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212101921",
            "telephone_number": "773-301-3730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 SCHENLEY RD # 100A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212102524",
            "telephone_number": "443-440-6125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5113 Falls Road Ter",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212101921",
            "country_code": "US",
            "telephone_number": "773-301-3730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AUTHENTIC SPACES COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-04",
        "last_updated": "2019-04-25",
        "status": "A",
        "authorized_official_last_name": "BYNUM",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER/CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "773-301-3730",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MD",
            "license": "05089",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.