Provider Demographics
NPI:1154281814
Name:MCCOY, ROSANNE M (LPC)
Entity type:Individual
Prefix:
First Name:ROSANNE
Middle Name:M
Last Name:MCCOY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16523 HUNTERS CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63040-1731
Mailing Address - Country:US
Mailing Address - Phone:636-344-0754
Mailing Address - Fax:
Practice Address - Street 1:2638 HIGHWAY 109 STE 203
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:MO
Practice Address - Zip Code:63040-1182
Practice Address - Country:US
Practice Address - Phone:636-344-0754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-14
Last Update Date:2025-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020009676101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty