Healthcare Provider Details

I. General information

NPI: 1376753004
Provider Name (Legal Business Name): ROBIN ALYSSA MCCOY LICDC LPCC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 HIGH ST NE
WARREN OH
44481-1222
US

IV. Provider business mailing address

320 HIGH ST NE
WARREN OH
44481-1222
US

V. Phone/Fax

Practice location:
  • Phone: 330-394-9090
  • Fax: 330-394-8163
Mailing address:
  • Phone: 330-394-9090
  • Fax: 330-394-8163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number991495
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE 0003374
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: