Healthcare Provider Details

I. General information

NPI: 1598682478
Provider Name (Legal Business Name): AMY MCCOY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

465 MAITLAND AVE
ALTAMONTE SPG FL
32701-5444
US

IV. Provider business mailing address

719 RUGBY ST APT B
ORLANDO FL
32804-4963
US

V. Phone/Fax

Practice location:
  • Phone: 407-761-5783
  • Fax:
Mailing address:
  • Phone: 407-761-5783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW23367
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: