Provider Demographics
NPI:1962171512
Name:JAYES, ARIN CALLANEN (LGPC, NCC)
Entity type:Individual
Prefix:
First Name:ARIN
Middle Name:CALLANEN
Last Name:JAYES
Suffix:
Gender:M
Credentials:LGPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1523 GREENDALE RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-2238
Mailing Address - Country:US
Mailing Address - Phone:202-380-6519
Mailing Address - Fax:
Practice Address - Street 1:1523 GREENDALE RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-2238
Practice Address - Country:US
Practice Address - Phone:202-380-6519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP11659101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional