Healthcare Provider Details

I. General information

NPI: 1639768161
Provider Name (Legal Business Name): EMILY S MCCOY LCPC ATR-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2021
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 WISCONSIN AVE APT B
OAK PARK IL
60302-5518
US

IV. Provider business mailing address

324 WISCONSIN AVE APT B
OAK PARK IL
60302-5518
US

V. Phone/Fax

Practice location:
  • Phone: 217-552-3638
  • Fax:
Mailing address:
  • Phone: 217-552-3638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180013498
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178014994
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: