Provider Demographics
NPI:1578704052
Name:QUEALLY, BARBARA (MC, LPC)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:
Last Name:QUEALLY
Suffix:
Gender:F
Credentials:MC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8308 WAGON WHEEL LN
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-2549
Mailing Address - Country:US
Mailing Address - Phone:970-216-6997
Mailing Address - Fax:
Practice Address - Street 1:8308 WAGON WHEEL LN
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-2549
Practice Address - Country:US
Practice Address - Phone:970-216-6997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-13
Last Update Date:2021-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC-1824101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO187406OtherSCHOOL COUNSELOR
CO51181771Medicaid
COLPC-1824OtherCOLORADO LICENSE