Provider Demographics
NPI:1407095664
Name:MCCOY, YVONNE (LPC)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:
Last Name:MCCOY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 CHISOLM CT
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-7033
Mailing Address - Country:US
Mailing Address - Phone:817-605-7001
Mailing Address - Fax:
Practice Address - Street 1:3221 W PIONEER PKWY
Practice Address - Street 2:
Practice Address - City:PANTEGO
Practice Address - State:TX
Practice Address - Zip Code:76013-4620
Practice Address - Country:US
Practice Address - Phone:817-276-9009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14435101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional