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NPI 1083700751

NPI 1083700751 : PETER E. MCCOY : NORTH LAS VEGAS, NV

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General NPI Number Information
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    NPI Number           |    1083700751
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    Entity Type          |    Individual 
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    Provider Name        |    PETER E. MCCOY
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/04/2006
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    Last Update Date     |    12/23/2024
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Provider Practice Location Address
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    Address Line         |    6900 N PECOS RD 
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    City                 |    NORTH LAS VEGAS
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    State                |    NV
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    Zip                  |    89086-4400
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    Country              |    US
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    Telephone            |    702-638-2744
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 752991 
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    City                 |    LAS VEGAS
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    State                |    NV
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    Zip                  |    89136-2991
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    Country              |    US
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    Telephone            |    702-638-2744
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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       |    IC-473
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    License Number State |    NV
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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       |    5683-C
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    License Number State |    NV
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