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General NPI Number Information
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NPI Number | 1841782075
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Entity Type | Individual
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Provider Name | ROY CECRLE MA, LPC
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Gender | Male
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Dates
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Enumeration Date | 06/04/2018
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 131 N TUSTIN AVE STE 100
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City | TUSTIN
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State | CA
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Zip | 92780-2937
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Country | US
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Telephone | 949-431-2225
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Fax |
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Provider Business Mailing Address
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Address Line | 925 E 3RD ST
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City | SANTA ANA
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State | CA
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Zip | 92701-4906
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Country | US
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Telephone | 682-521-6779
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 69415
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 69415
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 69415
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 17071
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License Number State | CA
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