Individual
MR. JEREMY ROYAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., LCPC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
BBH-LCPC-LIC-57158
MT
101YM0800X
Mental Health Counselor
LCPC-4866
ID
101YP2500X
Professional Counselor
Primary
BBH-LCPC-LIC57158
MT
Other
Enumeration date
09/08/2010
Last updated
05/18/2025
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