Provider Demographics
NPI:1508200064
Name:MCCOY, THOMASIN ELENA (PHD)
Entity Type:Individual
Prefix:DR
First Name:THOMASIN
Middle Name:ELENA
Last Name:MCCOY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 E WASHINGTON ST STE 205
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-3959
Mailing Address - Country:US
Mailing Address - Phone:319-358-6520
Mailing Address - Fax:319-538-0093
Practice Address - Street 1:325 E WASHINGTON ST STE 205
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-3959
Practice Address - Country:US
Practice Address - Phone:319-358-6520
Practice Address - Fax:319-538-0093
Is Sole Proprietor?:No
Enumeration Date:2013-04-26
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001251103G00000X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist