Tracey Andrea Royster-Bennett

Primary specialty

Rehabilitation PsychologistTaxonomy code 103TR0400X

Practice address

3455 Wilkens Ave Ste 203
Baltimore, MD 21229-5265

Phone

(443) 927-5050

NPI assigned

Sep 26, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Peace of Mind LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Baltimore, MD
  • NPI 1487314100
  NPD Authorized official
• Integrity Health Services LLC

  • Adult Mental Health Clinic/Center
  • Baltimore, MD
  • NPI 1265999866

  Single Specialty

  NPD

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

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537920000000",
    "number": "1669957544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 LIGHT ST UNIT 1301",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212021269",
            "telephone_number": "443-927-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 WILKENS AVE STE 203",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295265",
            "telephone_number": "443-927-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROYSTER-BENNETT",
        "first_name": "TRACEY",
        "middle_name": "ANDREA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-26",
        "last_updated": "2018-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Royal Roots LLC
• Nequaila Royal
• Walter Royal III, M.D.
• Cody Lee Royer, PT
• Samantha Royson, LCSWC
• Caitlin Marie Royster, RD, LDN
• Ciara Royster, BSN,RN
• Damel Jani Royster
• Kierra Royster
• Tashaun Royster

• Rehabilitation Psychologist in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Rehabilitation Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; 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.