Provider Demographics
NPI:1285814327
Name:QUINN, MONICA J (MA CSW)
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:J
Last Name:QUINN
Suffix:
Gender:F
Credentials:MA CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2139 ROSLYN RD
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-1051
Mailing Address - Country:US
Mailing Address - Phone:313-598-9010
Mailing Address - Fax:
Practice Address - Street 1:36250 DEQUINDRE RD
Practice Address - Street 2:SUITE 310
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-7143
Practice Address - Country:US
Practice Address - Phone:586-795-0569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010214721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical