Provider Demographics
NPI:1467855106
Name:MCCOY, JAMIE LYNN (MSW U/S)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:LYNN
Last Name:MCCOY
Suffix:
Gender:F
Credentials:MSW U/S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 W GENTRY AVE
Mailing Address - Street 2:
Mailing Address - City:CHECOTAH
Mailing Address - State:OK
Mailing Address - Zip Code:74426-2439
Mailing Address - Country:US
Mailing Address - Phone:918-473-1575
Mailing Address - Fax:
Practice Address - Street 1:229 W GENTRY AVE
Practice Address - Street 2:
Practice Address - City:CHECOTAH
Practice Address - State:OK
Practice Address - Zip Code:74426-2439
Practice Address - Country:US
Practice Address - Phone:918-473-1575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-08
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker