Individual
JACK HAMILTON MCCOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
418 LONGFELLOW AVE, SAINT LOUIS, MO 63122-3829
(314) 277-3839
Mailing address
418 LONGFELLOW AVE, SAINT LOUIS, MO 63122-3829
(314) 277-3839
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2023048726
MO
Other
Enumeration date
02/17/2025
Last updated
02/17/2025
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