Provider Demographics
NPI:1154489789
Name:CASSIDY-QUINN, JOSEPHINE (LICSW, LADC)
Entity Type:Individual
Prefix:MRS
First Name:JOSEPHINE
Middle Name:
Last Name:CASSIDY-QUINN
Suffix:
Gender:F
Credentials:LICSW, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1233 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-5381
Mailing Address - Country:US
Mailing Address - Phone:413-493-2075
Mailing Address - Fax:413-539-2436
Practice Address - Street 1:2112 RIVERDALE ST
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-1024
Practice Address - Country:US
Practice Address - Phone:413-827-4269
Practice Address - Fax:413-827-4204
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA113845101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)