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General NPI Number Information
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NPI Number | 1528459419
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Entity Type | Individual
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Provider Name | LAUREN MCCOY MFT
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Gender | Female
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Dates
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Enumeration Date | 02/12/2015
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Last Update Date | 07/06/2020
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Provider Practice Location Address
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Address Line | 701 N WALTON BLVD UNIT 6
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City | BENTONVILLE
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State | AR
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Zip | 72712-4548
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Country | US
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Telephone | 702-706-3284
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Fax |
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Provider Business Mailing Address
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Address Line | 2402 N JEREMIAH PL
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City | FAYETTEVILLE
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State | AR
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Zip | 72704-8649
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Country | US
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Telephone | 904-583-0405
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 01487
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | M1911012
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License Number State | AR
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