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NPI Code Detail

MEDICARE: DESTINY MCCOY

MEDICARE: DESTINY 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
1101YM0800XMental Health Counselor
2171W00000XContractor
31041C0700XClinical Social Worker65631TX

General Provider Information

NPI Number : 1548650153
Entity Type Code : Individual
Provider Name (Legal Business Name) : DESTINY MCCOY
Provider Business Mailing Address
First Line : 4141 SOUTHWEST FWY STE 510
Second Line :
City : HOUSTON
State : TX
Zip : 77027-7334
Country : US
Telephone Number : 832-699-7921
Fax Number :
Provider Business Practice Location Address
First Line : 4141 SOUTHWEST FWY STE 510
Second Line :
City : HOUSTON
State : TX
Zip : 77027-7334
Country : US
Telephone Number : 832-699-7921
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2015
Last Update Date : 11/15/2023

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Directions to “ DESTINY MCCOY ” Practice Location

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