Individual
MR. CHASE PATRICK QUEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICDC-CS; LPC-S; LSW
Contact information
Practice address
16149 STATE ROUTE 104, CHILLICOTHE, OH 45601-9701
(740) 701-2103
Mailing address
16149 STATE ROUTE 104, CHILLICOTHE, OH 45601-9701
(740) 701-2103
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
991715
OH
101YP2500X
Professional Counselor
C-0006302
OH
104100000X
Social Worker
S-0015211
OH
Other
Enumeration date
06/19/2014
Last updated
06/19/2014
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