Provider Demographics
NPI:1932536737
Name:ROYCE, SHONA GAIL (MED, LPCC)
Entity Type:Individual
Prefix:MRS
First Name:SHONA
Middle Name:GAIL
Last Name:ROYCE
Suffix:
Gender:F
Credentials:MED, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 ELM LOOP
Mailing Address - Street 2:
Mailing Address - City:HUSTONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40437-9186
Mailing Address - Country:US
Mailing Address - Phone:606-669-4968
Mailing Address - Fax:
Practice Address - Street 1:1714 PERRYVILLE RD STE 106
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-1392
Practice Address - Country:US
Practice Address - Phone:606-653-1062
Practice Address - Fax:606-328-5074
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-11
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY171653101YM0800X
101YP2500X, 1041C0700X, 101YM0800X
KY260471101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical