MEDICARE: SYDNI MCQUEEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1730039132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYDNI MCQUEEN

Provider Business Mailing Address
First Line	:	2674 CLEAR SPRINGS CT
Second Line	:
City	:	LAPEER
State	:	MI
Zip	:	48446-3295
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1460 WALTON BLVD STE 60
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48309-1729
Country	:	US
Telephone Number	:	248-608-4514
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2026
Last Update Date	:	02/03/2026

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