Provider Demographics
NPI:1427203777
Name:QUAMMIE, COLLIN (LCSW-R)
Entity Type:Individual
Prefix:MR
First Name:COLLIN
Middle Name:
Last Name:QUAMMIE
Suffix:
Gender:M
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 JENNIFER LN
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-1218
Mailing Address - Country:US
Mailing Address - Phone:914-674-0624
Mailing Address - Fax:914-674-0624
Practice Address - Street 1:350 CENTRAL PARK W
Practice Address - Street 2:APT 1F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6547
Practice Address - Country:US
Practice Address - Phone:917-301-5654
Practice Address - Fax:914-674-0624
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-28
Last Update Date:2012-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR04574111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical