Katherine McCoy, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

63661 Issued in TX

Practice address

1500 Corporate Cir
Southlake, TX 76092-5953

Phone

(817) 721-9330

NPI assigned

Jan 1, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 15, 2025 through Oct 15, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mindwell Therapy

  • Clinical Social Worker
  • Keller, TX
  • NPI 1922835610
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1609459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609459200000",
    "number": "1083202451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 GLORIA ST",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762482483",
            "telephone_number": "817-721-9330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 CORPORATE CIR",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760925953",
            "telephone_number": "817-721-9330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 William D Tate Ave",
            "address_purpose": "LOCATION",
            "city": "Grapevine",
            "state": "TX",
            "postal_code": "760513919",
            "country_code": "US",
            "telephone_number": "817-424-9013 x1755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "KATHERINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-01",
        "last_updated": "2021-01-01",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "63661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mbo Texas, PLLC
• Mboc Texas, PLLC
• Courtney McCartney, SLP
• Jennifer Wells McCauley, P.T.
• Taylor McCorkle
• Caitlyn McCready, LPC
• Macy McCready, M.S., CCC-SLP
• Shayla Dawn McCurdy
• Amy Lynn McDonald, P.A.
• Erin Jepson McGee, FNP

• Clinical Social Worker in Southlake, TX
• Providers in Southlake, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.