Healthcare Provider Details

I. General information

NPI: 1164707501
Provider Name (Legal Business Name): AARON MCCOY MSW, LSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2011
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3459 W 151ST ST
CLEVELAND OH
44111-2106
US

IV. Provider business mailing address

3459 W 151ST ST
CLEVELAND OH
44111-2106
US

V. Phone/Fax

Practice location:
  • Phone: 614-561-6729
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.1101319
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: