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General NPI Number Information
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NPI Number | 1003967076
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Entity Type | Individual
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Provider Name | RICHARD JON MCQUAID LPC,LPRC
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Gender | Male
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 11/15/2007
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Provider Practice Location Address
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Address Line | 4211 WALNEY RD
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City | CHANTILLY
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State | VA
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Zip | 20151-2923
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Country | US
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Telephone | 703-227-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 103 COLONIAL CT
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City | LOCUST GROVE
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State | VA
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Zip | 22508-5216
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Country | US
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Telephone | 540-972-0160
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PC00127400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0701004274
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License Number State | VA
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