MEDICARE: MELVIN 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	103T00000X	Psychologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548839020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELVIN MCCOY

Provider Business Mailing Address
First Line	:	402 PEAKE ST
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-6048
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	402 PEAKE ST
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-6048
Country	:	US
Telephone Number	:	219-852-9566
Fax Number	:

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

Provider Enumeration Date	:	06/21/2021
Last Update Date	:	06/21/2021

Similar Medicare Providers

1710581558 — MRS. CAITLIN RENEE BROWN MA, LPC
Practice Location Address:

416 PEAKE ST
LAKE CHARLES, LA
70601-6048

Practice Phone: 337-425-1293
Practice Fax:

1629135157 — KYLE E HOOGENDOORN DPM
Practice Location Address:

6048 LAKE WORTH BLVD
FORT WORTH, TX
76135-3706

Practice Phone: 817-336-1189
Practice Fax: 817-698-8281

1104965722 — MS. KARRIE MARKLAND-PAPENHEIM D.C.
Practice Location Address:

116 N C 470
LAKE PANASOFFKEE, FL
33538-6048

Practice Phone: 352-793-3337
Practice Fax: 352-793-3337

1821278151 — KANAYOCHUKWU KANNY JACQUELYNE ANYA M.D.
Practice Location Address:

6048 LAKE WORTH BLVD
FORT WORTH, TX
76135-3706

Practice Phone: 817-270-4243
Practice Fax: 817-270-4249

1316254063 — MARKLAND CHIROPRACTIC CLINIC, INC.
Practice Location Address:

116 N COUNTY ROAD 470
LAKE PANASOFFKEE, FL
33538-6048

Practice Phone: 352-793-3337
Practice Fax: 352-793-3337

1952701351 — CINDY MIDKIFF ATC
Practice Location Address:

612 LAKE POINT CIR
VIRGINIA BEACH, VA
23451-6048

Practice Phone: 757-536-7806
Practice Fax: 757-422-2367

Directions to “ MELVIN MCCOY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.