Provider Demographics
NPI:1962648337
Name:QUIRK, STUART WALTER (PHD)
Entity Type:Individual
Prefix:
First Name:STUART
Middle Name:WALTER
Last Name:QUIRK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 E MAIN ST STE B1
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29302-2004
Mailing Address - Country:US
Mailing Address - Phone:864-310-7252
Mailing Address - Fax:864-428-2275
Practice Address - Street 1:181 RIVERRUN DR
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-6406
Practice Address - Country:US
Practice Address - Phone:864-310-7252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-06
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1461103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1461OtherSTATE LICENSE