Healthcare Provider Details

I. General information

NPI: 1265378400
Provider Name (Legal Business Name): EMILY MCCOY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 N FEDERAL HWY STE 401
BOCA RATON FL
33431-5180
US

IV. Provider business mailing address

131 WENTWORTH CT
JUPITER FL
33458-2905
US

V. Phone/Fax

Practice location:
  • Phone: 203-364-7990
  • Fax:
Mailing address:
  • Phone: 203-364-7990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW23092
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: