Provider Demographics
NPI:1083169619
Name:MCCOY, DAVID II
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:MCCOY
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27160 WOODS EDGE LN
Mailing Address - Street 2:
Mailing Address - City:WALKER
Mailing Address - State:LA
Mailing Address - Zip Code:70785-6423
Mailing Address - Country:US
Mailing Address - Phone:985-687-9991
Mailing Address - Fax:
Practice Address - Street 1:27160 WOODS EDGE LN
Practice Address - Street 2:
Practice Address - City:WALKER
Practice Address - State:LA
Practice Address - Zip Code:70785-6423
Practice Address - Country:US
Practice Address - Phone:985-687-9991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health