Provider Demographics
NPI:1760216709
Name:GEORGE, ROYCE JEFFERSON (LPC-S)
Entity type:Individual
Prefix:DR
First Name:ROYCE
Middle Name:JEFFERSON
Last Name:GEORGE
Suffix:
Gender:M
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E MCKINNEY ST UNIT 1581
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76202-4265
Mailing Address - Country:US
Mailing Address - Phone:817-706-8175
Mailing Address - Fax:
Practice Address - Street 1:101 E MCKINNEY ST UNIT 1581
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76202-4265
Practice Address - Country:US
Practice Address - Phone:817-706-8175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10525101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional