Individual
DR. KENNETH D MCCOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, HSPP
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
20040951A
IN
103T00000X
Psychologist
20040951A
IN
103TA0700X
Adult Development & Aging Psychologist
20040951A
IN
103TB0200X
Cognitive & Behavioral Psychologist
20040951A
IN
103TC1900X
Counseling Psychologist
20040951A
IN
103TF0000X
Family Psychologist
20040951A
IN
103TM1800X
Intellectual & Developmental Disabilities Psychologist
20040951A
IN
103TP2701X
Group Psychotherapy Psychologist
Primary
20040951A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000180198
BCBS PROVIDER NO
IN
01
—
11385019
CAQH PROVIDER NO
IN
01
—
11639000
MAGELLAN PROVIDER NO
IN
01
—
1297474
UNITED PROVIDER NO
IN
01
—
251319
VALUE OPTIONS PROVIDER NO
IN
Enumeration date
11/06/2006
Last updated
09/11/2025
Update your record
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