Provider Demographics
NPI:1720261548
Name:MC COY, LAURA L (LPC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:L
Last Name:MC COY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6298 SW GRAND OAKS DR APT I302
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-4869
Mailing Address - Country:US
Mailing Address - Phone:541-760-5706
Mailing Address - Fax:
Practice Address - Street 1:6298 SW GRAND OAKS DR APT I302
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97333-4869
Practice Address - Country:US
Practice Address - Phone:541-760-5706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-14
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
ORC3955101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)