Provider Demographics
NPI:1508739889
Name:MCCOY, DAVID D (LSW)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:D
Last Name:MCCOY
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:MR
Other - First Name:DAVID
Other - Middle Name:D
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1431 S HICKS ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-4818
Mailing Address - Country:US
Mailing Address - Phone:856-296-9528
Mailing Address - Fax:
Practice Address - Street 1:42 DELSEA DR S
Practice Address - Street 2:
Practice Address - City:GLASSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08028-2621
Practice Address - Country:US
Practice Address - Phone:844-422-3632
Practice Address - Fax:856-881-5508
Is Sole Proprietor?:No
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL07287800104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker