Provider Demographics
NPI:1427021823
Name:QUINN, PATRICK CHARLES (PHD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:CHARLES
Last Name:QUINN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 UNION ST S
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-5047
Mailing Address - Country:US
Mailing Address - Phone:704-706-9218
Mailing Address - Fax:866-607-0407
Practice Address - Street 1:37 MARKET ST SW
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-5007
Practice Address - Country:US
Practice Address - Phone:704-706-9218
Practice Address - Fax:866-607-0407
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-11-8160103K00000X
NC1586103T00000X, 103TA0700X, 103TB0200X, 103TC2200X, 103TM1800X, 103T00000X
NC1585103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities