Provider Demographics
NPI:1851499537
Name:MOBLEY-MCCOY, ANGELA L (MA, LSPE)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:L
Last Name:MOBLEY-MCCOY
Suffix:
Gender:F
Credentials:MA, LSPE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1937 BELCARO DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-3709
Mailing Address - Country:US
Mailing Address - Phone:865-689-6744
Mailing Address - Fax:865-689-6744
Practice Address - Street 1:1930 ALCOA HWY STE 435 BLDG A
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1520
Practice Address - Country:US
Practice Address - Phone:865-544-9030
Practice Address - Fax:865-544-6675
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPE0000001547101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN41114851OtherBCBS TN ID NUMBER