Provider Demographics
NPI:1730840810
Name:MCCOY, DAVA (LCMFT)
Entity type:Individual
Prefix:MRS
First Name:DAVA
Middle Name:
Last Name:MCCOY
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11490 S LAKECREST DR
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-7525
Mailing Address - Country:US
Mailing Address - Phone:949-246-5321
Mailing Address - Fax:
Practice Address - Street 1:11490 S LAKECREST DR
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-7525
Practice Address - Country:US
Practice Address - Phone:949-246-5321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-31
Last Update Date:2021-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53715101YM0800X, 106H00000X
KS03042101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health