Provider Demographics
NPI:1215754007
Name:MCCOYWRIGHT, ANEECA M (CHW)
Entity type:Individual
Prefix:
First Name:ANEECA
Middle Name:M
Last Name:MCCOYWRIGHT
Suffix:
Gender:F
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1633 PEMBROKE AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43203-1266
Mailing Address - Country:US
Mailing Address - Phone:614-374-8960
Mailing Address - Fax:
Practice Address - Street 1:1633 PEMBROKE AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43203-1266
Practice Address - Country:US
Practice Address - Phone:614-374-8960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
OH172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator