Active NPI
Costella Marie Roberts McKoy, LPC
- Professional Counselor
- Pinehurst, NC
National Provider Identifier
1952593261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6650
- Practice address
- 10 Parker LN
Suite 2
Pinehurst, NC 28374-7903 - Phone
- (910) 638-5966
- Fax
- (910) 692-3573
- NPI assigned
- Aug 10, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6650 | NC | Primary |
Addresses
Primary practice location
10 Parker LN
Suite 2
Pinehurst, NC 28374-7903
Mailing address
PO Box 1394
Pinehurst, NC 28370-1394
Phone (910) 295-5580
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6650 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327017600000",
"number": "1952593261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1394",
"city": "PINEHURST",
"state": "NC",
"postal_code": "283701394",
"telephone_number": "910-295-5580",
"fax_number": "910-692-3573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 PARKER LN",
"address_2": "SUITE 2",
"city": "PINEHURST",
"state": "NC",
"postal_code": "283747903",
"telephone_number": "910-638-5966",
"fax_number": "910-692-3573"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKOY",
"first_name": "COSTELLA",
"middle_name": "MARIE ROBERTS",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-10",
"last_updated": "2012-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "6650",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pinehurst, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.