Provider Demographics
NPI:1801086541
Name:MCCOY, DUSTIN SCOTT (LPC)
Entity type:Individual
Prefix:MR
First Name:DUSTIN
Middle Name:SCOTT
Last Name:MCCOY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 E TWOHIG AVE STE 600
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76903-6486
Mailing Address - Country:US
Mailing Address - Phone:325-944-2561
Mailing Address - Fax:
Practice Address - Street 1:2001 COLORADO AVE
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76901-3905
Practice Address - Country:US
Practice Address - Phone:325-944-2561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61097101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional