Jackelin McCoy

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

10075 Levone Ave
Truckee, CA 96161-0443

Phone

(530) 582-7814

NPI assigned

May 25, 2021

Sex

Female

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)

Not enrolled

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1982279576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10046 NICOLAS DR UNIT C",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961611869",
            "telephone_number": "310-999-9642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10075 LEVONE AVE",
            "city": "TRUCKEE",
            "state": "CA",
            "postal_code": "961610443",
            "telephone_number": "530-582-7814"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10833 Donner Pass Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Truckee",
            "state": "CA",
            "postal_code": "961614851",
            "country_code": "US",
            "telephone_number": "530-582-3505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "JACKELIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-25",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Ann Mayle, MS, CPNP
• Calvin Mayo
• Sharon Mayo, C.D.
• Kaylyn Mays
• Carla Beryl McClure, L.AC.; OMD; DIPL.OM
• Spencer James McCune
• Kristyn McDougall, APRN
• Deonne Zena McLean, MS, LMFT
• Susan Carol McMullen, N.P.02/07/1966
• Brenda Medina-Islas

• Addiction (Substance Use Disorder) Counselor in Truckee, CA
• Providers in Truckee, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.