Provider Demographics
NPI:1700533809
Name:ROYAL PSYCHOTHERAPY SERVICES, PLLC
Entity Type:Organization
Organization Name:ROYAL PSYCHOTHERAPY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JERRICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROYAL
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LCMHC
Authorized Official - Phone:910-689-3681
Mailing Address - Street 1:952 GOLF HOUSE RD W STE I653
Mailing Address - Street 2:
Mailing Address - City:WHITSETT
Mailing Address - State:NC
Mailing Address - Zip Code:27377-9286
Mailing Address - Country:US
Mailing Address - Phone:910-689-3681
Mailing Address - Fax:
Practice Address - Street 1:952 GOLF HOUSE RD W STE I653
Practice Address - Street 2:
Practice Address - City:WHITSETT
Practice Address - State:NC
Practice Address - Zip Code:27377-9286
Practice Address - Country:US
Practice Address - Phone:910-689-3681
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty