Provider Demographics
NPI:1396537940
Name:QUEEN, MELISSA KAYE (LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:KAYE
Last Name:QUEEN
Suffix:
Gender:F
Credentials:LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:488 JEWELED MESA CT
Mailing Address - Street 2:
Mailing Address - City:HORIZON CITY
Mailing Address - State:TX
Mailing Address - Zip Code:79928-7287
Mailing Address - Country:US
Mailing Address - Phone:509-710-7694
Mailing Address - Fax:
Practice Address - Street 1:488 JEWELED MESA CT
Practice Address - Street 2:
Practice Address - City:HORIZON CITY
Practice Address - State:TX
Practice Address - Zip Code:79928-7287
Practice Address - Country:US
Practice Address - Phone:509-710-7694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX98747101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor