Provider Demographics
NPI:1083097042
Name:KRISTI MCCOY, COUNSELING AND ASSESSMENT, PLLC
Entity Type:Organization
Organization Name:KRISTI MCCOY, COUNSELING AND ASSESSMENT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR/EXAMINER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:RHEA
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC
Authorized Official - Phone:580-504-9232
Mailing Address - Street 1:PO BOX 101
Mailing Address - Street 2:
Mailing Address - City:SPRINGER
Mailing Address - State:OK
Mailing Address - Zip Code:73458-0101
Mailing Address - Country:US
Mailing Address - Phone:580-504-9232
Mailing Address - Fax:
Practice Address - Street 1:301 W MAIN ST
Practice Address - Street 2:SUITE 329
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-6337
Practice Address - Country:US
Practice Address - Phone:580-504-9232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4582101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty