Provider Demographics
NPI:1447548649
Name:MCCOY, IRLINDA (BSC, BHRS)
Entity type:Individual
Prefix:
First Name:IRLINDA
Middle Name:
Last Name:MCCOY
Suffix:
Gender:F
Credentials:BSC, BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 N PEORIA AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74106-2512
Mailing Address - Country:US
Mailing Address - Phone:918-794-0197
Mailing Address - Fax:
Practice Address - Street 1:2625 N PEORIA AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74106-2512
Practice Address - Country:US
Practice Address - Phone:918-794-0197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health