Provider Demographics
NPI:1629530100
Name:MCCOY, MICHAEL (MA, LPC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:MCCOY
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3302
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37927
Mailing Address - Country:US
Mailing Address - Phone:720-307-6564
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 3302
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37927-3302
Practice Address - Country:US
Practice Address - Phone:720-307-6564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-03
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No172V00000XOther Service ProvidersCommunity Health Worker