Provider Demographics
NPI:1922475953
Name:ROYAL, KENNETHA DANIELLE (LPC)
Entity Type:Individual
Prefix:MISS
First Name:KENNETHA
Middle Name:DANIELLE
Last Name:ROYAL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4620 N BRAESWOOD BLVD
Mailing Address - Street 2:#346
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-2845
Mailing Address - Country:US
Mailing Address - Phone:832-851-8825
Mailing Address - Fax:
Practice Address - Street 1:4620 N BRAESWOOD BLVD
Practice Address - Street 2:#346
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-2845
Practice Address - Country:US
Practice Address - Phone:832-851-8825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-25
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71950101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional