Provider Demographics
NPI:1548495583
Name:MCCOY, SARAH (LICSW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MCCOY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:BOSTELLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:8000 28TH AVE NW APT 220
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-4552
Mailing Address - Country:US
Mailing Address - Phone:206-295-9006
Mailing Address - Fax:
Practice Address - Street 1:8000 28TH AVE NW APT 220
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98117-4552
Practice Address - Country:US
Practice Address - Phone:206-295-9006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-20
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW600674731041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical