Provider Demographics
NPI:1821785098
Name:ELIZABETH ROYSTON LLC
Entity Type:Organization
Organization Name:ELIZABETH ROYSTON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:ROYSTON
Authorized Official - Suffix:
Authorized Official - Credentials:LBA, BCBA, M ED
Authorized Official - Phone:704-458-2436
Mailing Address - Street 1:150 BW THOMAS DR STE 115A
Mailing Address - Street 2:
Mailing Address - City:TEGA CAY
Mailing Address - State:SC
Mailing Address - Zip Code:29708-7230
Mailing Address - Country:US
Mailing Address - Phone:803-814-5503
Mailing Address - Fax:
Practice Address - Street 1:150 BW THOMAS DR STE 115A
Practice Address - Street 2:
Practice Address - City:TEGA CAY
Practice Address - State:SC
Practice Address - Zip Code:29708-7230
Practice Address - Country:US
Practice Address - Phone:803-814-5503
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty