Provider Demographics
NPI:1710316765
Name:QUINN, AUSTIN (LICSW)
Entity Type:Individual
Prefix:MR
First Name:AUSTIN
Middle Name:
Last Name:QUINN
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 TUCKERMAN ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-1138
Mailing Address - Country:US
Mailing Address - Phone:202-923-0426
Mailing Address - Fax:
Practice Address - Street 1:64 NEW YORK AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-3320
Practice Address - Country:US
Practice Address - Phone:202-763-3208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-09
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500799081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical