Provider Demographics
NPI:1033776364
Name:MCKOY, DENISE MARIE (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:MARIE
Last Name:MCKOY
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7413 QUANTICO WAY
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21060-8796
Mailing Address - Country:US
Mailing Address - Phone:443-790-2261
Mailing Address - Fax:
Practice Address - Street 1:7413 QUANTICO WAY
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21060-8796
Practice Address - Country:US
Practice Address - Phone:443-790-2261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-22
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDG10639104100000X
MD277931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker