Provider Demographics
NPI:1992024335
Name:QUIRK, REBECCA ELISE (LCSW)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ELISE
Last Name:QUIRK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5313 EASTHORPE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-5733
Mailing Address - Country:US
Mailing Address - Phone:919-397-5187
Mailing Address - Fax:
Practice Address - Street 1:5313 EASTHORPE DR
Practice Address - Street 2:APT/SUITE
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-5733
Practice Address - Country:US
Practice Address - Phone:919-397-5187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-25
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical