Provider Demographics
NPI:1275745135
Name:MCCOY, LAURA ANNE (BA)
Entity Type:Individual
Prefix:MISS
First Name:LAURA
Middle Name:ANNE
Last Name:MCCOY
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 COMMODORE CT
Mailing Address - Street 2:
Mailing Address - City:BARNEGAT
Mailing Address - State:NJ
Mailing Address - Zip Code:08005-1411
Mailing Address - Country:US
Mailing Address - Phone:732-350-2120
Mailing Address - Fax:
Practice Address - Street 1:88 SCHOOLHOUSE RD
Practice Address - Street 2:
Practice Address - City:WHITING
Practice Address - State:NJ
Practice Address - Zip Code:08759-3051
Practice Address - Country:US
Practice Address - Phone:732-350-2120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor