Provider Demographics
NPI:1407290729
Name:SINCLAIR, ROY KELLEY (LPCA)
Entity Type:Individual
Prefix:MR
First Name:ROY
Middle Name:KELLEY
Last Name:SINCLAIR
Suffix:
Gender:M
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18515 STATESVILLE RD
Mailing Address - Street 2:SUITE C-01
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-5702
Mailing Address - Country:US
Mailing Address - Phone:704-892-5339
Mailing Address - Fax:704-892-5939
Practice Address - Street 1:18515 STATESVILLE RD
Practice Address - Street 2:SUITE C-01
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-5702
Practice Address - Country:US
Practice Address - Phone:704-892-5339
Practice Address - Fax:704-892-5939
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10071101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor