Healthcare Provider Details

I. General information

NPI: 1356574032
Provider Name (Legal Business Name): NATASHA MONIC MCCOY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2009
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 W MAIN ST
WALNUT RIDGE AR
72476-1431
US

IV. Provider business mailing address

1815 PLEASANT GROVE RD
JONESBORO AR
72405-7870
US

V. Phone/Fax

Practice location:
  • Phone: 870-886-5303
  • Fax: 870-886-7002
Mailing address:
  • Phone: 870-933-6886
  • Fax: 870-933-9395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberP2505002
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: