Provider Demographics
NPI:1982079638
Name:MCCOOG, EVE HELEN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:EVE
Middle Name:HELEN
Last Name:MCCOOG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:GLASSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08028-9761
Mailing Address - Country:US
Mailing Address - Phone:609-512-9212
Mailing Address - Fax:
Practice Address - Street 1:328 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:GLASSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08028-9761
Practice Address - Country:US
Practice Address - Phone:609-512-9212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-07
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC058126001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical