Provider Demographics
NPI:1467173369
Name:MCQUEEN, JADYN INEZ (LPC)
Entity Type:Individual
Prefix:
First Name:JADYN
Middle Name:INEZ
Last Name:MCQUEEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11311 CORNELL PARK DR STE 205
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-1891
Mailing Address - Country:US
Mailing Address - Phone:513-940-7175
Mailing Address - Fax:513-982-2525
Practice Address - Street 1:11311 CORNELL PARK DR STE 205
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-1891
Practice Address - Country:US
Practice Address - Phone:513-940-7175
Practice Address - Fax:513-982-2525
Is Sole Proprietor?:No
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2204549101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor