Provider Demographics
NPI:1235907700
Name:QUINN, BEVERLY M (LPC)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:M
Last Name:QUINN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:BEVERLY
Other - Middle Name:M
Other - Last Name:QUINN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:1806 HARMON RD
Mailing Address - Street 2:
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-1207
Mailing Address - Country:US
Mailing Address - Phone:610-246-8651
Mailing Address - Fax:
Practice Address - Street 1:809 N BETHLEHEM PIKE
Practice Address - Street 2:BUILDING C, SUITE G
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002
Practice Address - Country:US
Practice Address - Phone:484-531-6681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005082101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional