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Individual

MRS. CARMEN BONITA MCCOY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
710 FRANKLIN ST, MICHIGAN CITY, IN 46360-3563
(219) 872-6200
(219) 879-2915
Mailing address
710 FRANKLIN ST, MICHIGAN CITY, IN 46360-3563
(219) 872-6200
(219) 879-2915

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
LSW0000004647
TN
1041C0700X
Clinical Social Worker
Primary
34003386A
IN

Other

Enumeration date
12/13/2007
Last updated
10/30/2020
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