Provider Demographics
NPI:1902360225
Name:MCCOY, KARA LYNN
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:LYNN
Last Name:MCCOY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:LYNN
Other - Last Name:BELSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1283
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MT
Mailing Address - Zip Code:59019-1283
Mailing Address - Country:US
Mailing Address - Phone:307-202-0746
Mailing Address - Fax:
Practice Address - Street 1:4289 HIGHWAY 78
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MT
Practice Address - Zip Code:59019-7493
Practice Address - Country:US
Practice Address - Phone:307-202-0746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health