Provider Demographics
NPI:1669167524
Name:ROYCROFT, ALLEN
Entity type:Individual
Prefix:
First Name:ALLEN
Middle Name:
Last Name:ROYCROFT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 WATER ST
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-3058
Mailing Address - Country:US
Mailing Address - Phone:617-538-4677
Mailing Address - Fax:
Practice Address - Street 1:37 WATER ST
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-3058
Practice Address - Country:US
Practice Address - Phone:617-538-4677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor