MEDICARE: MACI NICOLE MCCOY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor		TX

General Provider Information

NPI Number	:	1013840123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MACI NICOLE MCCOY

Provider Business Mailing Address
First Line	:	579 SILVER VALLEY RD
Second Line	:
City	:	DURANT
State	:	OK
Zip	:	74701-8412
Country	:	US
Telephone Number	:	580-380-3519
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 CONGRESS AVE STE 7.300
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78701-1320
Country	:	US
Telephone Number	:	512-305-7700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2026
Last Update Date	:	06/08/2026

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Directions to “ MACI NICOLE MCCOY ” Practice Location

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