Provider Demographics
NPI:1033223136
Name:QUINN, JEANINE MARIE (MA NCC LPC)
Entity Type:Individual
Prefix:
First Name:JEANINE
Middle Name:MARIE
Last Name:QUINN
Suffix:
Gender:F
Credentials:MA NCC LPC
Other - Prefix:
Other - First Name:NINA
Other - Middle Name:MARIE
Other - Last Name:QUINN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA NCC LPC
Mailing Address - Street 1:208 JUNCTION LN
Mailing Address - Street 2:
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-4684
Mailing Address - Country:US
Mailing Address - Phone:610-505-2641
Mailing Address - Fax:
Practice Address - Street 1:103 S HIGH ST
Practice Address - Street 2:#5
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-3262
Practice Address - Country:US
Practice Address - Phone:610-719-0530
Practice Address - Fax:610-429-5821
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004217101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional