Provider Demographics
NPI:1386997518
Name:MCCOY, BEVERLY WOODS (BCBA)
Entity type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:WOODS
Last Name:MCCOY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:BEVERLY
Other - Middle Name:GAIL
Other - Last Name:WOODS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 4100
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25504-4100
Mailing Address - Country:US
Mailing Address - Phone:304-399-4405
Mailing Address - Fax:
Practice Address - Street 1:2631 STATE ROUTE 34
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:WV
Practice Address - Zip Code:25213-7797
Practice Address - Country:US
Practice Address - Phone:304-397-6909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-25
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1-12-12159103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst