Provider Demographics
NPI:1336388602
Name:QUIRINA, JENNIFER JANEEN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:JANEEN
Last Name:QUIRINA
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 1:5500 CHANTILLY CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE IN THE HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60156-5822
Mailing Address - Country:US
Mailing Address - Phone:708-712-2330
Mailing Address - Fax:
Practice Address - Street 1:5500 CHANTILLY CIR
Practice Address - Street 2:
Practice Address - City:LAKE IN THE HILLS
Practice Address - State:IL
Practice Address - Zip Code:60156-5822
Practice Address - Country:US
Practice Address - Phone:708-712-2330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-11
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS288391041C0700X
IL1490187291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical