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General NPI Number Information
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NPI Number | 1043382542
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Entity Type | Individual
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Provider Name | KELVIN DREW MCCOY LCSW
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Gender | Male
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 1950 FM 2673
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City | CANYON LAKE
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State | TX
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Zip | 78133-4758
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Country | US
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Telephone | 254-488-8558
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Fax |
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Provider Business Mailing Address
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Address Line | 110 WATTS LN
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City | CANYON LAKE
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State | TX
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Zip | 78133-6400
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Country | US
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Telephone | 254-488-8558
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 37880
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.008220
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 62348
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License Number State | TX
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