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General NPI Number Information
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NPI Number | 1972137917
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Entity Type | Individual
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Provider Name | LATISHA D MCCOY PHD, LPC
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Gender | Female
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Dates
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Enumeration Date | 02/28/2020
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Last Update Date | 08/22/2025
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Provider Practice Location Address
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Address Line | 1515 MARKET ST STE 1200
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City | PHILADELPHIA
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State | PA
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Zip | 19102-1932
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Country | US
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Telephone | 267-216-7548
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Fax | 484-376-8005
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Provider Business Mailing Address
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Address Line | 1515 MARKET ST STE 1200
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City | PHILADELPHIA
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State | PA
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Zip | 19102-1932
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Country | US
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Telephone | 484-496-4694
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Fax | 484-496-4694
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC011708
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License Number State | PA
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