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General NPI Number Information
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NPI Number | 1083097042
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Entity Type | Organization
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Legal Business Name | KRISTI MCCOY, COUNSELING AND ASSESSMENT, PLLC
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Dates
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Enumeration Date | 07/08/2015
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Last Update Date | 07/08/2015
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Provider Practice Location Address
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Address Line | 301 W MAIN ST SUITE 329
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City | ARDMORE
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State | OK
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Zip | 73401-6337
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Country | US
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Telephone | 580-504-9232
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 101
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City | SPRINGER
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State | OK
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Zip | 73458-0101
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Country | US
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Telephone | 580-504-9232
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Fax |
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Authorized Official
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Title or Position | COUNSELOR/EXAMINER
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Name | MRS. KRISTI RHEA MCCOY
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Credential | M.ED., LPC
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Telephone | 580-504-9232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 4582
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License Number State | OK
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