Provider Demographics
NPI:1942773924
Name:MCCOY-LEBLANC, CORTNEY CARIN
Entity Type:Individual
Prefix:
First Name:CORTNEY
Middle Name:CARIN
Last Name:MCCOY-LEBLANC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 RANCHEROS DR STE 5
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-3042
Mailing Address - Country:US
Mailing Address - Phone:760-761-0515
Mailing Address - Fax:
Practice Address - Street 1:751 RANCHEROS DR STE 5
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-3042
Practice Address - Country:US
Practice Address - Phone:760-761-0515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-02
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)