Provider Demographics
NPI:1477034940
Name:QUINN, LAUREEN ALISON (LCSW)
Entity Type:Individual
Prefix:
First Name:LAUREEN
Middle Name:ALISON
Last Name:QUINN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 FOREST EDGE LN APT D
Mailing Address - Street 2:
Mailing Address - City:WOODLAND PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80863-2419
Mailing Address - Country:US
Mailing Address - Phone:484-347-2611
Mailing Address - Fax:
Practice Address - Street 1:402 FOREST EDGE LN APT D
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:CO
Practice Address - Zip Code:80863-2419
Practice Address - Country:US
Practice Address - Phone:484-347-2611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099254431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical