Provider Demographics
NPI:1376662627
Name:ABUKHALIL-QUINONEZ, ZINAH SAMIE (LICSW)
Entity Type:Individual
Prefix:
First Name:ZINAH
Middle Name:SAMIE
Last Name:ABUKHALIL-QUINONEZ
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2464 MASSACHUSETTS AVE STE 313
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-1648
Mailing Address - Country:US
Mailing Address - Phone:617-877-2495
Mailing Address - Fax:
Practice Address - Street 1:850 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-4001
Practice Address - Country:US
Practice Address - Phone:617-414-5245
Practice Address - Fax:617-638-6836
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA114487101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health