Provider Demographics
NPI:1891562427
Name:MCCOY, JANELLE MO'NEA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JANELLE
Middle Name:MO'NEA
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 1:5325 ELKHORN BLVD # 1036
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95842-2526
Mailing Address - Country:US
Mailing Address - Phone:916-713-3775
Mailing Address - Fax:916-581-8701
Practice Address - Street 1:1020 MISSOURI ST
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-6112
Practice Address - Country:US
Practice Address - Phone:916-713-3775
Practice Address - Fax:916-581-8701
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1076401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical