Provider Demographics
NPI:1639321656
Name:MCCOY, ELLA KATHLEEN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ELLA
Middle Name:KATHLEEN
Last Name:MCCOY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 N. MARKWELL PLACE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73127
Mailing Address - Country:US
Mailing Address - Phone:405-201-4675
Mailing Address - Fax:405-603-3075
Practice Address - Street 1:1601 N MARKWELL PL
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73127-3046
Practice Address - Country:US
Practice Address - Phone:405-201-4675
Practice Address - Fax:405-603-3075
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK34761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical