Healthcare Provider Details

I. General information

NPI: 1922710136
Provider Name (Legal Business Name): MIKEA MCCOY PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2022
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4259 W SWAMP RD STE 404
DOYLESTOWN PA
18902-1033
US

IV. Provider business mailing address

4259 W SWAMP RD STE 404
DOYLESTOWN PA
18902-1033
US

V. Phone/Fax

Practice location:
  • Phone: 610-892-3800
  • Fax: 484-468-1412
Mailing address:
  • Phone: 610-892-3800
  • Fax: 484-468-1412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP026813
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: