1043208861 NPI number — MRS. PM MARKIE MCCOY DCSW LSW LMFT BCD

Table of content: MRS. PM MARKIE MCCOY DCSW LSW LMFT BCD (NPI 1043208861)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043208861 NPI number — MRS. PM MARKIE MCCOY DCSW LSW LMFT BCD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCCOY
Provider First Name:
PM
Provider Middle Name:
MARKIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
DCSW LSW LMFT BCD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BOBINET
Provider Other First Name:
PM
Provider Other Middle Name:
MARKIE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSW
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1043208861
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
812 DRIPPING SPRINGS DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EDMOND
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73034-8763
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-348-3655
Provider Business Mailing Address Fax Number:
405-348-7208

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3600 W SIMMONS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EDMOND
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73034-8163
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-348-3655
Provider Business Practice Location Address Fax Number:
405-348-7208
Provider Enumeration Date:
10/06/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  LCSW231 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 106H00000X , with the licence number: LMFT110 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)