Active NPI
Christa Ann McCoy, MSW LICSW
- Clinical Social Worker
- Eagan, MN
National Provider Identifier
1902591183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 16495
- Practice address
- 1110 Northwood Dr Apt 214
Eagan, MN 55121-2067 - Phone
- (651) 890-9988
- NPI assigned
- Apr 5, 2023
- Sex
- Female
- 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 | 16495 | MN | Primary |
Addresses
Primary practice location
1110 Northwood Dr Apt 214
Eagan, MN 55121-2067
Mailing address
1110 Northwood Dr Apt 214
Eagan, MN 55121-2067
Phone (651) 890-9988
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 |
|---|---|---|---|
| 16495 | MN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680652800000",
"number": "1902591183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1110 NORTHWOOD DR APT 214",
"city": "EAGAN",
"state": "MN",
"postal_code": "551212067",
"telephone_number": "651-890-9988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1110 NORTHWOOD DR APT 214",
"city": "EAGAN",
"state": "MN",
"postal_code": "551212067",
"telephone_number": "651-890-9988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCOY",
"first_name": "CHRISTA",
"middle_name": "ANN",
"credential": "MSW LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-04-05",
"last_updated": "2023-04-05",
"certification_date": "2023-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "16495",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eagan, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.