Healthcare Provider Details

I. General information

NPI: 1053250498
Provider Name (Legal Business Name): QUEEN COUNSELING OF OHIO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6525 MEADOWCROFT LN
MAUMEE OH
43537-1128
US

IV. Provider business mailing address

6525 MEADOWCROFT LN
MAUMEE OH
43537-1128
US

V. Phone/Fax

Practice location:
  • Phone: 419-552-8293
  • Fax:
Mailing address:
  • Phone: 419-552-8293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: ANNA G QUEEN
Title or Position: THERAPIST
Credential: LPCC
Phone: 419-552-8293