Provider Demographics
NPI:1598354292
Name:QUINONES, ELIZABETH ANGELICA (LMHC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANGELICA
Last Name:QUINONES
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 1:130 SCHAEFER ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-1113
Mailing Address - Country:US
Mailing Address - Phone:917-975-9517
Mailing Address - Fax:
Practice Address - Street 1:130 SCHAEFER ST APT 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-1113
Practice Address - Country:US
Practice Address - Phone:917-975-9517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-16
Last Update Date:2022-06-15
Deactivation Date:2021-01-18
Deactivation Code:
Reactivation Date:2021-03-19
Provider Licenses
StateLicense IDTaxonomies
NY010984-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health