SAMUEL MCCOY CPRM - NPI 1700702859 - Peer Specialist in Detroit, MI

Q: What is the provider's specialty?

The provider's specialty is Peer Specialist with taxonomy code 175T00000X.

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About Samuel Mccoy Cprm NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMUEL MCCOY CPRM (NPI 1700702859) is an individual peer specialist in Detroit, Michigan, licensed in Michigan (M200758379939) and active in the NPI registry since June 2026.

NPPES Registry Identity

NPI1700702859

Entity TypeIndividualMale

Primary Taxonomy175T00000X

Provider Legal NameSAMUEL MCCOYCredential: CPRM

Location Address2011 CLEMENTS STDetroit, MI 48238-3484

Mailing Address2011 Clements StDetroit, MI 48238-3484 · (313) 962-9446 · Fax (313) 502-5147

Phone(313) 962-9446

Fax(313) 502-5147

Sole ProprietorNo

Enumeration DateJune 24, 2026

NPPES CertifiedJune 24, 2026

✔ NPI 1700702859 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers

Taxonomy Code175T00000X

License✔ Licensed in MI · M200758379939

Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

2011 CLEMENTS ST, Detroit, MI 48238

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Frequently Asked Questions

What is Samuel Mccoy's NPI number?

The NPI number assigned to this healthcare provider is 1700702859, enumerated as an "individual" on June 24, 2026.

Where is the provider located?

The provider is located at 2011 CLEMENTS ST DETROIT, MI 48238 and the phone number is (313) 962-9446.

What is the provider's specialty?

Peer Specialist with taxonomy code 175T00000X.