Provider Demographics
NPI:1720951775
Name:MCCOY, RITA MEMU (LGPC)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:MEMU
Last Name:MCCOY
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 SILVER VIEW LN
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-4030
Mailing Address - Country:US
Mailing Address - Phone:301-221-3979
Mailing Address - Fax:
Practice Address - Street 1:14502 GREENVIEW DR STE 400
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-4234
Practice Address - Country:US
Practice Address - Phone:240-413-4923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP14637101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty