Provider Demographics
NPI:1962591685
Name:MCLOY, RICHARD J (MS, CCC-SLP/L)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:J
Last Name:MCLOY
Suffix:
Gender:M
Credentials:MS, CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1502
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34656-1502
Mailing Address - Country:US
Mailing Address - Phone:727-848-6747
Mailing Address - Fax:727-847-3107
Practice Address - Street 1:6926 HILLS DR
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-2710
Practice Address - Country:US
Practice Address - Phone:727-848-6747
Practice Address - Fax:727-847-3107
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA2369235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL881395700Medicaid
FLS1376OtherBLUE CROSS BLUE SHIELD