Provider Demographics
NPI:1922165927
Name:QUIRK, MARY ELIZABETH (MARY QUIRK, MA,LPC)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:ELIZABETH
Last Name:QUIRK
Suffix:
Gender:F
Credentials:MARY QUIRK, MA,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 MIDDLEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748-1336
Mailing Address - Country:US
Mailing Address - Phone:732-706-5433
Mailing Address - Fax:
Practice Address - Street 1:45 COUNTY RD., ROUTE 537 WEST
Practice Address - Street 2:
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722-1622
Practice Address - Country:US
Practice Address - Phone:732-303-6999
Practice Address - Fax:732-303-6991
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00282600101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional