Provider Demographics
NPI:1083886295
Name:QUEEN, LUCAS BOYD (LPC-MHSP, ACS, MAC)
Entity Type:Individual
Prefix:DR
First Name:LUCAS
Middle Name:BOYD
Last Name:QUEEN
Suffix:
Gender:M
Credentials:LPC-MHSP, ACS, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7317 EDGEFIELD DR STE 110
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-1425
Mailing Address - Country:US
Mailing Address - Phone:423-421-5992
Mailing Address - Fax:
Practice Address - Street 1:4001 ROSSVILLE BLVD STE 110
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37407-2546
Practice Address - Country:US
Practice Address - Phone:423-476-1933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-27
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC00000542101YA0400X, 101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional