Provider Demographics
NPI:1215430533
Name:MCCOY, ELSPETH (LISW-S)
Entity type:Individual
Prefix:
First Name:ELSPETH
Middle Name:
Last Name:MCCOY
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:ELSPETH
Other - Middle Name:
Other - Last Name:NEVILLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LISW-S
Mailing Address - Street 1:329 N WEST ST
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-4331
Mailing Address - Country:US
Mailing Address - Phone:419-221-3072
Mailing Address - Fax:419-225-8878
Practice Address - Street 1:1229 LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:VAN WERT
Practice Address - State:OH
Practice Address - Zip Code:45891-1877
Practice Address - Country:US
Practice Address - Phone:419-238-1695
Practice Address - Fax:419-238-1007
Is Sole Proprietor?:No
Enumeration Date:2018-03-13
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.2203537-SUPV1041C0700X
OHI.22035371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH15559325OtherCAQH
OH0290329Medicaid