Royal Ivey Wellness, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

6380 Issued in SC

Legal business name

ROYAL IVEY WELLNESS, INC.

Practice address

2712 Middleburg Dr Ste 206
Columbia, SC 29204-2415

Phone

(803) 757-4325

NPI assigned

Jun 26, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Keysha Reynolds, NCC, LPCNPI 1366851727

Title

Counselor/Owner

Phone

(803) 747-4325

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Keysha A. Reynolds Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Keysha Reynolds, NCC, LPC

  • Mental Health Counselor
  • Columbia, SC
  • NPI 1366851727
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1498435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498435200000",
    "number": "1174043558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2712 MIDDLEBURG DR STE 206",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042415",
            "telephone_number": "803-757-4325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2712 MIDDLEBURG DR STE 206",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042415",
            "telephone_number": "803-757-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROYAL IVEY WELLNESS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-26",
        "last_updated": "2017-06-26",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "KEYSHA",
        "authorized_official_title_or_position": "COUNSELOR/OWNER",
        "authorized_official_telephone_number": "803-747-4325",
        "authorized_official_credential": "NCC, LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "SC",
            "license": "6380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PC1741",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Keysha A. Reynolds",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tonya Rowland
• Mykala Renee Rowley
• Ajeet Roy, DO
• Nancy A Roy, FNP
• Royal Health, PC
• Royal Transport Service
• RR Diagnostic Labs
• RR Diagnostic Labs LLC
• RR Diagnostic Labs LLC
• RSW Med LLC

• Community/Behavioral Health Agency in Columbia, SC
• Providers in Columbia, SC by specialty
• Community/Behavioral Health Agency in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.