Provider Demographics
NPI:1346350816
Name:MCCLOSKEY, ROYA D (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ROYA
Middle Name:D
Last Name:MCCLOSKEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:ROYA
Other - Middle Name:D
Other - Last Name:HENDRICKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:600 CREEK RD
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348
Mailing Address - Country:US
Mailing Address - Phone:610-444-4151
Mailing Address - Fax:610-925-3455
Practice Address - Street 1:600 CREEK RD
Practice Address - Street 2:
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348
Practice Address - Country:US
Practice Address - Phone:610-444-4151
Practice Address - Fax:610-925-3455
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005554L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA595632Medicare ID - Type Unspecified