Provider Demographics
NPI:1437640604
Name:QUINN, MONICA SUE (LMHC)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:SUE
Last Name:QUINN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7232 LUMBER PORT DR
Mailing Address - Street 2:
Mailing Address - City:RUSKIN
Mailing Address - State:FL
Mailing Address - Zip Code:33573-0131
Mailing Address - Country:US
Mailing Address - Phone:941-545-3247
Mailing Address - Fax:
Practice Address - Street 1:7232 LUMBER PORT DR
Practice Address - Street 2:
Practice Address - City:RUSKIN
Practice Address - State:FL
Practice Address - Zip Code:33573-0131
Practice Address - Country:US
Practice Address - Phone:941-545-3247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12365101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health