Provider Demographics
NPI:1417165747
Name:ROYER, MARCIA LEE (MA, LPC, LMFT, LMSW)
Entity Type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:LEE
Last Name:ROYER
Suffix:
Gender:F
Credentials:MA, LPC, LMFT, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 ALLEN AVE
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:MI
Mailing Address - Zip Code:48801-2404
Mailing Address - Country:US
Mailing Address - Phone:989-463-5837
Mailing Address - Fax:
Practice Address - Street 1:319 W SUPERIOR ST
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1646
Practice Address - Country:US
Practice Address - Phone:989-463-8277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401000297101YM0800X
MI68010663301041C0700X
MI4101006063106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0896565OtherBCBSM INDIVIDUAL PROVIDER
MI08965659802Medicare ID - Type Unspecified