Healthcare Provider Details

I. General information

NPI: 1336631159
Provider Name (Legal Business Name): RONNIE TYSON MCQUAY LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2018
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 S CLAIRBORNE RD STE A
OLATHE KS
66062-4108
US

IV. Provider business mailing address

13028 ELIZABETH AVE
BONNER SPRINGS KS
66012-6701
US

V. Phone/Fax

Practice location:
  • Phone: 913-307-0300
  • Fax:
Mailing address:
  • Phone: 913-314-2132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3252
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: