Provider Demographics
NPI:1205982360
Name:QUINONES, CARMEN L (MED LMHC)
Entity type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:L
Last Name:QUINONES
Suffix:
Gender:F
Credentials:MED LMHC
Other - Prefix:
Other - First Name:CARMEN
Other - Middle Name:
Other - Last Name:QUINONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:147 NORMAN STREET
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01105
Mailing Address - Country:US
Mailing Address - Phone:413-788-0929
Mailing Address - Fax:413-732-5362
Practice Address - Street 1:2155 MAIN STREET
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104
Practice Address - Country:US
Practice Address - Phone:413-736-0395
Practice Address - Fax:413-734-1651
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5989103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling