Provider Demographics
NPI:1609377720
Name:MCQUEEN WHITFIELD, DANA LATOYA (LPC,NCC)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:LATOYA
Last Name:MCQUEEN WHITFIELD
Suffix:
Gender:F
Credentials:LPC,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28001 NORTH TURNPIKE ROAD
Mailing Address - Street 2:POST OFFICE BOX 172
Mailing Address - City:WAGRAM
Mailing Address - State:NC
Mailing Address - Zip Code:28396
Mailing Address - Country:US
Mailing Address - Phone:910-318-4398
Mailing Address - Fax:
Practice Address - Street 1:28001 NORTH TURNPIKE ROAD
Practice Address - Street 2:POST OFFICE BOX 172
Practice Address - City:WAGRAM
Practice Address - State:NC
Practice Address - Zip Code:28396
Practice Address - Country:US
Practice Address - Phone:910-318-4398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-23
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10583101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional