Provider Demographics
NPI:1235868829
Name:BRANKLIN, ROY JAMES (LPC)
Entity Type:Individual
Prefix:MR
First Name:ROY
Middle Name:JAMES
Last Name:BRANKLIN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5820 JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-6709
Mailing Address - Country:US
Mailing Address - Phone:540-903-6276
Mailing Address - Fax:
Practice Address - Street 1:5820 JACKSON RD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-6709
Practice Address - Country:US
Practice Address - Phone:540-903-6276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701011528101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty