Individual
MRS. KATIE MARTIN MCCOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
178 MIDDLE ST, SUITE 300, PORTLAND, ME 04101-4075
(207) 773-0073
Mailing address
178 MIDDLE ST, SUITE 300, PORTLAND, ME 04101-4075
(207) 773-0073
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC7301
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
272140099
—
ME
Enumeration date
11/21/2006
Last updated
07/09/2007
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