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General NPI Number Information
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NPI Number | 1790586956
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Entity Type | Individual
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Provider Name | SIOBHAN MARIE MCCOY LMSW
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Gender | Female
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Dates
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Enumeration Date | 03/24/2025
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 2280 E GRAND RIVER AVE
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City | HOWELL
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State | MI
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Zip | 48843-8503
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Country | US
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Telephone | 517-546-4126
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Fax |
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Provider Business Mailing Address
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Address Line | 6025 SAN LURAY RD
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City | GREGORY
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State | MI
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Zip | 48137-9565
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Country | US
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Telephone | 734-657-2455
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6801111113
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License Number State | MI
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