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General NPI Number Information
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NPI Number | 1538655006
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Entity Type | Organization
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Legal Business Name | MCCOY COUNSELING LLC
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Dates
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Enumeration Date | 07/07/2018
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Last Update Date | 03/03/2022
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Provider Practice Location Address
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Address Line | 513 MAIN ST
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72114-5329
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Country | US
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Telephone | 501-777-5969
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Fax |
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Provider Business Mailing Address
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Address Line | 4109 REDFORD CT
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City | BENTON
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State | AR
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Zip | 72019-2564
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Country | US
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Telephone | 501-777-5969
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Fax |
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Authorized Official
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Title or Position | OWNER, COUNSELOR
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Name | KELLEE MCCOY
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Credential | LPC, LMFT
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Telephone | 501-205-4474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | P1803036
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License Number State | AR
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