Individual provider Active NPI

Mary E McCoy, LCSW

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1184937575
Registry record updated Jul 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW015621 Issued in PA
Practice address
1420 Walnut St
Suite 902
Philadelphia, PA 19102-4017
Phone
(267) 259-3659
Fax
(215) 735-2020
NPI assigned
Jul 14, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW015621 PA Primary

Addresses

Primary practice location

1420 Walnut St
Suite 902
Philadelphia, PA 19102-4017

Mailing address

1420 Walnut St
Suite 902
Philadelphia, PA 19102-4017
Phone (267) 259-3659

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CW015621PAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1279065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279065600000",
    "number": "1184937575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 WALNUT ST",
            "address_2": "SUITE 902",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191024017",
            "telephone_number": "267-259-3659",
            "fax_number": "215-735-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 WALNUT ST",
            "address_2": "SUITE 902",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191024017",
            "telephone_number": "267-259-3659",
            "fax_number": "215-735-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-14",
        "last_updated": "2010-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW015621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.