Provider Demographics
NPI:1619161189
Name:QUINN, ANDREW BRIAN (LMHC CAP)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:BRIAN
Last Name:QUINN
Suffix:
Gender:M
Credentials:LMHC CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 E BAY ST
Mailing Address - Street 2:#1
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33801
Mailing Address - Country:US
Mailing Address - Phone:863-683-9600
Mailing Address - Fax:863-688-3770
Practice Address - Street 1:215 E BAY ST
Practice Address - Street 2:#1
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801
Practice Address - Country:US
Practice Address - Phone:863-683-9600
Practice Address - Fax:863-688-3770
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCAP 1882101YA0400X
FLMH 5735101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)