Provider Demographics
NPI:1558644625
Name:MCCOY, DONALD A (LPC)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:A
Last Name:MCCOY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 DELL DALE RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-2425
Mailing Address - Country:US
Mailing Address - Phone:646-248-9332
Mailing Address - Fax:
Practice Address - Street 1:29 DELL DALE RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-2425
Practice Address - Country:US
Practice Address - Phone:646-248-9332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-24
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001926101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional