Provider Demographics
NPI:1659908754
Name:CHARLES MCQUEEN, NATASHA G (LCPC, NCC, RPA)
Entity type:Individual
Prefix:DR
First Name:NATASHA
Middle Name:G
Last Name:CHARLES MCQUEEN
Suffix:
Gender:F
Credentials:LCPC, NCC, RPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9419 COMMON BROOK RD STE 208
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-7570
Mailing Address - Country:US
Mailing Address - Phone:347-792-0905
Mailing Address - Fax:
Practice Address - Street 1:9419 COMMON BROOK RD STE 208
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-7570
Practice Address - Country:US
Practice Address - Phone:410-864-0211
Practice Address - Fax:410-618-4163
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-26
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC14169101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health