Provider Demographics
NPI:1003270265
Name:MCKOY, ROSA MARIA (LPC)
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:MARIA
Last Name:MCKOY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 ARK RD STE 208L
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-3190
Mailing Address - Country:US
Mailing Address - Phone:609-721-3068
Mailing Address - Fax:
Practice Address - Street 1:33 THIRD ST STE 101
Practice Address - Street 2:
Practice Address - City:BORDENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08505-1369
Practice Address - Country:US
Practice Address - Phone:609-865-2670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-13
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00204900101YM0800X
NJ37PC00714400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health