Active NPI
David Michael McQueeney, PH.D.
- Clinical Child & Adolescent Psychologist
- Cumming, GA
National Provider Identifier
1437200763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- PSY000682
- Practice address
- 327 Dahlonega St
BLDG 1600
Cumming, GA 30040-2480 - Phone
- (770) 317-3365
- Fax
- (770) 993-3139
- NPI assigned
- Jan 15, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | PSY000682 | GA | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | PSY000682 | GA | Primary |
| Counseling Psychologist | 103TC1900X | PSY000682 | GA | |
| Clinical Psychologist | 103TC0700X | PSY000682 | GA |
Addresses
Primary practice location
327 Dahlonega St
BLDG 1600
Cumming, GA 30040-2480
Mailing address
1540 Bainbridge LN
Roswell, GA 30076-1619
Phone (770) 993-1876
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000237784F | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY000682 | GA | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330041600000",
"number": "1437200763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1540 BAINBRIDGE LN",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300761619",
"telephone_number": "770-993-1876",
"fax_number": "770-993-3139"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "327 DAHLONEGA ST",
"address_2": "BLDG 1600",
"city": "CUMMING",
"state": "GA",
"postal_code": "300402480",
"telephone_number": "770-317-3365",
"fax_number": "770-993-3139"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCQUEENEY",
"first_name": "DAVID",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-15",
"last_updated": "2012-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "GA",
"license": "PSY000682",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "GA",
"license": "PSY000682",
"primary": true
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "GA",
"license": "PSY000682",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "GA",
"license": "PSY000682",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000237784F",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cumming, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.