Provider Demographics
NPI:1346079936
Name:ROYALTY BEHAVIORAL AND COUNSELING SERVICES
Entity type:Organization
Organization Name:ROYALTY BEHAVIORAL AND COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KENDELLA
Authorized Official - Middle Name:L
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:313-658-9580
Mailing Address - Street 1:26614 W CHICAGO
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48239-2231
Mailing Address - Country:US
Mailing Address - Phone:313-658-9580
Mailing Address - Fax:313-612-9090
Practice Address - Street 1:26614 W CHICAGO
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-2231
Practice Address - Country:US
Practice Address - Phone:313-658-9580
Practice Address - Fax:313-612-9090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty