Healthcare Provider Details

I. General information

NPI: 1174031058
Provider Name (Legal Business Name): OLIVIA MCCAMMON LPC, MT-BC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: OLIVIA COX

II. Dates (important events)

Enumeration Date: 01/13/2018
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 LAUREL RD STE 102
VOORHEES NJ
08043-8301
US

IV. Provider business mailing address

413 N WARWICK RD APT 34B
SOMERDALE NJ
08083-1960
US

V. Phone/Fax

Practice location:
  • Phone: 856-772-5809
  • Fax:
Mailing address:
  • Phone: 215-565-5083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37PC01167000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: