Provider Demographics
NPI:1790655363
Name:MCQUINN, SANDRA
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:MCQUINN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:MCQUINN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC, LCDC
Mailing Address - Street 1:66 S CALLA LILY CT
Mailing Address - Street 2:
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-4569
Mailing Address - Country:US
Mailing Address - Phone:979-922-5033
Mailing Address - Fax:
Practice Address - Street 1:66 S CALLA LILY CT
Practice Address - Street 2:
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-4569
Practice Address - Country:US
Practice Address - Phone:979-922-5033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-10
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX94416101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional