Individual provider Active NPI

Sherilyn Marie Queen, LMFT

  • Marriage & Family Therapist
  • Dawsonville, GA
National Provider Identifier
1154068120
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT001947 Issued in GA
Practice address
671 Lumpkin Campground Rd S Ste 100
Dawsonville, GA 30534-0931
Phone
(678) 866-8777
NPI assigned
May 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFT001947 GA Primary

Addresses

Primary practice location

671 Lumpkin Campground Rd S Ste 100
Dawsonville, GA 30534-0931

Mailing address

3405 Caney Creek LN
Cumming, GA 30041-1135
Phone (229) 560-1218

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250106002973 GA Practitioner - Marriage and Family Therapist 4880122704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgia Mountains Community ServicesGroup PAC ID 8921094400, 27 clinicians

Practice addresses (Care Compare)

4331 Thurmon Tanner Rd
Flowery Branch, GA 30542-2829
Phone (678) 513-5700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Mountains Community Services CurrentSince Nov 1, 2024 Accepting new patients
Georgia Mountains Community Services PastSince Apr 6, 2025 Accepting new patients

Locations

125 N Corners Pkwy
Cumming, GA 30040
Phone (678) 341-3840

150A Johnson St
Dahlonega, GA 30533
Phone (706) 864-6822

671 Lumpkin Campground Rd S
Ste 100
Dawsonville, GA 30534
Phone (678) 866-8776

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1652918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1154068120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3405 CANEY CREEK LN",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300411135",
            "telephone_number": "229-560-1218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "671 LUMPKIN CAMPGROUND RD S STE 100",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305340931",
            "telephone_number": "678-866-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUEEN",
        "first_name": "SHERILYN",
        "middle_name": "MARIE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-19",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "MFT001947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dawsonville, GA

Sources for this page

Verify at the official NPI Registry.