Provider Demographics
NPI:1801039029
Name:ROYNE, TERRY SUZANNE (LCSW)
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:SUZANNE
Last Name:ROYNE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 HERBER AVE
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-2003
Mailing Address - Country:US
Mailing Address - Phone:518-506-8758
Mailing Address - Fax:
Practice Address - Street 1:295 VALLEY VIEW BLVD
Practice Address - Street 2:
Practice Address - City:RENSSELAER
Practice Address - State:NY
Practice Address - Zip Code:12144-9307
Practice Address - Country:US
Practice Address - Phone:518-285-8100
Practice Address - Fax:518-285-8145
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-17
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0446741041C0700X
NY321661163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No163WH1000XNursing Service ProvidersRegistered NurseHospice