Provider Demographics
NPI:1922389782
Name:MCCOY, MICHELLE L (LLMSW)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:L
Last Name:MCCOY
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 ARNET ST
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-5706
Mailing Address - Country:US
Mailing Address - Phone:734-558-4759
Mailing Address - Fax:734-879-1569
Practice Address - Street 1:103 ARNET ST
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-5706
Practice Address - Country:US
Practice Address - Phone:734-558-4759
Practice Address - Fax:734-879-1569
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-06
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker