Provider Demographics
NPI:1942053780
Name:QUINN, RYAN EDWARD (LMHCA)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:EDWARD
Last Name:QUINN
Suffix:
Gender:M
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 BALD HILL RD STE 517
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-6100
Mailing Address - Country:US
Mailing Address - Phone:401-732-1500
Mailing Address - Fax:401-738-1085
Practice Address - Street 1:400 BALD HILL RD STE 517
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-6100
Practice Address - Country:US
Practice Address - Phone:401-732-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00181-A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health