Provider Demographics
NPI:1336631159
Name:MCQUAY, RONNIE TYSON (LPC)
Entity Type:Individual
Prefix:
First Name:RONNIE
Middle Name:TYSON
Last Name:MCQUAY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24997 WOLCOTT RD
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66048-7234
Mailing Address - Country:US
Mailing Address - Phone:913-314-2132
Mailing Address - Fax:
Practice Address - Street 1:6221 RICHARDS DR
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66216-1724
Practice Address - Country:US
Practice Address - Phone:913-248-1943
Practice Address - Fax:913-248-1994
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3252101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional