Provider Demographics
NPI:1336622729
Name:HUNDLEY, QUINTEISHA JENKINS (LPC)
Entity Type:Individual
Prefix:MRS
First Name:QUINTEISHA
Middle Name:JENKINS
Last Name:HUNDLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4040 BROADWAY STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-6300
Mailing Address - Country:US
Mailing Address - Phone:877-504-8504
Mailing Address - Fax:855-420-6402
Practice Address - Street 1:4040 BROADWAY STE 200
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-6300
Practice Address - Country:US
Practice Address - Phone:877-504-8504
Practice Address - Fax:855-420-6402
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-11
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7137101YP2500X
171M00000X
TX85667101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator