MEDICARE: QUEEN COUNSELING OF OHIO LLC

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1053250498
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUEEN COUNSELING OF OHIO LLC

Provider Business Mailing Address
First Line	:	6525 MEADOWCROFT LN
Second Line	:
City	:	MAUMEE
State	:	OH
Zip	:	43537-1128
Country	:	US
Telephone Number	:	419-552-8293
Fax Number	:

Provider Business Practice Location Address
First Line	:	6525 MEADOWCROFT LN
Second Line	:
City	:	MAUMEE
State	:	OH
Zip	:	43537-1128
Country	:	US
Telephone Number	:	419-552-8293
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	ANNA G QUEEN
Credential	:	LPCC
Telephone Number	:	419-552-8293

Provider Enumeration Date	:	03/27/2026
Last Update Date	:	03/27/2026

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Directions to “QUEEN COUNSELING OF OHIO LLC ” Practice Location

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