Provider Demographics
NPI:1861750085
Name:MCCOOL, BILLIE JO (LPC)
Entity type:Individual
Prefix:MS
First Name:BILLIE
Middle Name:JO
Last Name:MCCOOL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 S MAIN ST
Mailing Address - Street 2:STE 1E
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-4172
Mailing Address - Country:US
Mailing Address - Phone:605-225-1010
Mailing Address - Fax:605-225-1017
Practice Address - Street 1:14 S MAIN ST
Practice Address - Street 2:STE 1E
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-4172
Practice Address - Country:US
Practice Address - Phone:605-225-1010
Practice Address - Fax:605-225-1017
Is Sole Proprietor?:No
Enumeration Date:2012-04-25
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC7216101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDLPC7216OtherLICENSE