Provider Demographics
NPI:1033385372
Name:KAYKOV, ALLY (LPC)
Entity Type:Individual
Prefix:
First Name:ALLY
Middle Name:
Last Name:KAYKOV
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 1:170 RIVERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-1224
Mailing Address - Country:US
Mailing Address - Phone:732-300-5664
Mailing Address - Fax:
Practice Address - Street 1:170 RIVERWOOD DR
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-1224
Practice Address - Country:US
Practice Address - Phone:732-300-5664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00334200101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional