Individual provider Active NPI

Eli McCoy-Johnson

  • Clinical Social Worker
  • Havre de Grace, MD
National Provider Identifier
1265356505
Registry record updated Aug 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34888 Issued in MD
Practice address
800 Tydings LN
Havre de Grace, MD 21078-2132
Phone
(800) 799-4673
NPI assigned
Aug 7, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2026

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 34888 MD Primary

Addresses

Primary practice location

800 Tydings LN
Havre de Grace, MD 21078-2132

Mailing address

800 Tydings LN
Havre de Grace, MD 21078-2132

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

NPI Registry JSON

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

{
    "created_epoch": "1786060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786060800000",
    "number": "1265356505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 TYDINGS LN",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210782132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 TYDINGS LN",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210782132",
            "telephone_number": "800-799-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY-JOHNSON",
        "first_name": "ELI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-07",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "34888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Havre de Grace, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2026; 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.