Willie Ray McCoy III, LCSW-A

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P013183 Issued in NC

Practice address

3640 Westgate Center Cir Ste a
Winston Salem, NC 27103-3056

Phone

(704) 237-4240

NPI assigned

Mar 29, 2019

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553904000000",
    "number": "1780145821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3640 WESTGATE CENTER CIR STE A",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033056",
            "telephone_number": "704-237-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 WESTGATE CENTER CIR STE A",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033056",
            "telephone_number": "704-237-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "WILLIE",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LCSW-A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-29",
        "last_updated": "2019-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P013183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tenika Chique McCorkle, DNP, FNP-BC
• Michael Joseph McCormack Jr., M.D.
• Andrew Sean McCormick, PT
• Morgan Taylor McCoy, MD
• Saleema S McCoy, LCSWA
• Hayley Rebekah McCraw, LCMHCA
• Lindsey Elizabeth McCready, M.ED., BCBA, LBA
• Michael Conor McCrory, M.D.
• Jayden McCullough
• Leonard McCullough

• Clinical Social Worker in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2019; 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.