Provider Demographics
NPI:1518931419
Name:QUINN, PAULA CARROLL (LPC)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:CARROLL
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 1:1912A TRENT RD
Mailing Address - Street 2:STE 9
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560
Mailing Address - Country:US
Mailing Address - Phone:252-638-7005
Mailing Address - Fax:252-638-1774
Practice Address - Street 1:1912A TRENT RD
Practice Address - Street 2:STE 9
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560
Practice Address - Country:US
Practice Address - Phone:252-638-7005
Practice Address - Fax:252-638-1774
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC85061OtherNBCC
NCPC0015OtherNCBLPC
NC6102439Medicaid