MEDICARE: DR. DOROTHY VIRGINIA MCCOY LPC

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	1915	SC
2	101YP2500X	Professional Counselor	9295	NC

General Provider Information

NPI Number	:	1760488423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOROTHY VIRGINIA MCCOY LPC

Provider Business Mailing Address
First Line	:	241 SAINT MARYS RD
Second Line	:
City	:	HILLSBOROUGH
State	:	NC
Zip	:	27278-2521
Country	:	US
Telephone Number	:	919-245-1034
Fax Number	:

Provider Business Practice Location Address
First Line	:	241 SAINT MARYS RD
Second Line	:
City	:	HILLSBOROUGH
State	:	NC
Zip	:	27278-2521
Country	:	US
Telephone Number	:	919-245-1034
Fax Number	:

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

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	07/20/2012

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