Provider Demographics
NPI:1902110802
Name:ROY, MARLEEN ANN (ED, MS, LMHC)
Entity type:Individual
Prefix:
First Name:MARLEEN
Middle Name:ANN
Last Name:ROY
Suffix:
Gender:F
Credentials:ED, MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 NW FEDERAL HWY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-1019
Mailing Address - Country:US
Mailing Address - Phone:772-403-5844
Mailing Address - Fax:
Practice Address - Street 1:850 NW FEDERAL HWY
Practice Address - Street 2:SUITE 150
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-1019
Practice Address - Country:US
Practice Address - Phone:772-403-5844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-03
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11181101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health