Provider Demographics
NPI:1003597337
Name:MCQUEEN, JOHN TROY (LPC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:TROY
Last Name:MCQUEEN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 ROSEDOWN WAY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-3029
Mailing Address - Country:US
Mailing Address - Phone:678-925-4545
Mailing Address - Fax:
Practice Address - Street 1:685 ROSEDOWN WAY
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-3029
Practice Address - Country:US
Practice Address - Phone:678-925-4545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004809101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional