Provider Demographics
NPI:1972843639
Name:QUINLY, ELLEN (LSCSW)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:QUINLY
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6155 OAK ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64113-2240
Mailing Address - Country:US
Mailing Address - Phone:816-333-0606
Mailing Address - Fax:816-523-5418
Practice Address - Street 1:6155 OAK ST
Practice Address - Street 2:SUITE E
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64113-2240
Practice Address - Country:US
Practice Address - Phone:816-333-0606
Practice Address - Fax:816-523-5418
Is Sole Proprietor?:No
Enumeration Date:2013-02-18
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical