Provider Demographics
NPI:1891932133
Name:QUINN, MAYA C (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:MAYA
Middle Name:C
Last Name:QUINN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:MAYA
Other - Middle Name:C
Other - Last Name:BERHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:654 SPRINGFIELD AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-1078
Mailing Address - Country:US
Mailing Address - Phone:908-930-9185
Mailing Address - Fax:908-505-3622
Practice Address - Street 1:654 SPRINGFIELD AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:BERKELEY HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07922-1078
Practice Address - Country:US
Practice Address - Phone:908-930-9185
Practice Address - Fax:908-505-3622
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2018-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054181001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical