Healthcare Provider Details

I. General information

NPI: 1780180216
Provider Name (Legal Business Name): CHRISTEL MCKOY LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2018
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 HOKE LOOP RD
FAYETTEVILLE NC
28314-6489
US

IV. Provider business mailing address

1440 HOKE LOOP RD
FAYETTEVILLE NC
28314-6489
US

V. Phone/Fax

Practice location:
  • Phone: 910-257-7063
  • Fax: 910-630-2278
Mailing address:
  • Phone: 910-257-7063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number7819
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number13840
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9822
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: