Provider Demographics
NPI:1447239454
Name:QUINN, MARCIA KAY (LPC)
Entity Type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:KAY
Last Name:QUINN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4212 MONROE DR
Mailing Address - Street 2:UNIT D
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-6960
Mailing Address - Country:US
Mailing Address - Phone:303-440-8117
Mailing Address - Fax:303-583-0825
Practice Address - Street 1:2043 PEARL ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-4429
Practice Address - Country:US
Practice Address - Phone:303-440-8117
Practice Address - Fax:303-583-0825
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2691101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO2691OtherLICENSE NUMBER