Provider Demographics
NPI:1790111631
Name:MCCOY, RICHARD LEE (MA, NCC, LCPC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:LEE
Last Name:MCCOY
Suffix:
Gender:M
Credentials:MA, NCC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 CASS ST STE 3
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:IL
Mailing Address - Zip Code:60098-3208
Mailing Address - Country:US
Mailing Address - Phone:815-345-3400
Mailing Address - Fax:
Practice Address - Street 1:134 CASS ST STE 3
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:IL
Practice Address - Zip Code:60098-3208
Practice Address - Country:US
Practice Address - Phone:815-345-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.008683101YP2500X
IL180010971101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional