Provider Demographics
NPI:1013369867
Name:QUEEN, SARAH (LPCC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:QUEEN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 MULL AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-7502
Mailing Address - Country:US
Mailing Address - Phone:330-867-5603
Mailing Address - Fax:330-873-3439
Practice Address - Street 1:900 MULL AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313
Practice Address - Country:US
Practice Address - Phone:330-867-5603
Practice Address - Fax:330-873-3439
Is Sole Proprietor?:No
Enumeration Date:2016-07-05
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE. 1100351101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional