Provider Demographics
NPI:1346785607
Name:MCCOY, ASHLEY J (LSW)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:J
Last Name:MCCOY
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1175 NEWARK RD
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-2618
Mailing Address - Country:US
Mailing Address - Phone:740-454-0738
Mailing Address - Fax:740-588-6452
Practice Address - Street 1:1175 NEWARK RD
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-2618
Practice Address - Country:US
Practice Address - Phone:740-454-0738
Practice Address - Fax:740-588-6452
Is Sole Proprietor?:No
Enumeration Date:2016-12-22
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1451361104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker