Active NPI
Cameron Roben McCoy, LLMSW
- Clinical Social Worker
- Ann Arbor, MI
National Provider Identifier
1619600996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6851103400
- Practice address
- 2750 Carpenter Rd Ste 5
Ann Arbor, MI 48108-1170 - Phone
- (586) 585-6061
- NPI assigned
- Jul 5, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6851103400 | MI | Primary |
Addresses
Primary practice location
2750 Carpenter Rd Ste 5
Ann Arbor, MI 48108-1170
Mailing address
30602 Oakridge Manor Dr
Roseville, MI 48066-7738
Phone (586) 585-6061
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6851103400 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656979200000",
"number": "1619600996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30602 OAKRIDGE MANOR DR",
"city": "ROSEVILLE",
"state": "MI",
"postal_code": "480667738",
"telephone_number": "586-585-6061"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2750 CARPENTER RD STE 5",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481081170",
"telephone_number": "586-585-6061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCOY",
"first_name": "CAMERON",
"middle_name": "ROBEN",
"credential": "LLMSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-07-05",
"last_updated": "2022-07-05",
"certification_date": "2022-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6851103400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.