Provider Demographics
NPI:1568157170
Name:QUINN, KARI (LMSW)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:
Last Name:QUINN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 SUMMERHAVEN DR N
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-3136
Mailing Address - Country:US
Mailing Address - Phone:315-882-5834
Mailing Address - Fax:
Practice Address - Street 1:433 SUMMERHAVEN DR N
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-3136
Practice Address - Country:US
Practice Address - Phone:315-882-5834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY113167-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker