Provider Demographics
NPI:1265917652
Name:MACCOY, MARIE CHOQUETTE (LICSW, CDP, CMHS, MH)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:CHOQUETTE
Last Name:MACCOY
Suffix:
Gender:F
Credentials:LICSW, CDP, CMHS, MH
Other - Prefix:MRS
Other - First Name:MARIE
Other - Middle Name:CHOQUETTE
Other - Last Name:MACCOY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MARIE T CHOQUETTE
Mailing Address - Street 1:4230 198TH ST SW
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-6762
Mailing Address - Country:US
Mailing Address - Phone:425-260-2909
Mailing Address - Fax:
Practice Address - Street 1:4230 198TH ST SW
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-6762
Practice Address - Country:US
Practice Address - Phone:425-260-2909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60436297101YM0800X
WA60272965101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health