Provider Demographics
NPI:1649403783
Name:MCCOY, DEBBIE KINCAID (LPC)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:KINCAID
Last Name:MCCOY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 CONCORDIA AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-5113
Mailing Address - Country:US
Mailing Address - Phone:318-362-3270
Mailing Address - Fax:318-362-5245
Practice Address - Street 1:3200 CONCORDIA AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-5113
Practice Address - Country:US
Practice Address - Phone:318-362-3270
Practice Address - Fax:318-362-5245
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-24
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2629101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)