Provider Demographics
NPI:1457159691
Name:RICH, QUIN MARILYN (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:QUIN
Middle Name:MARILYN
Last Name:RICH
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3420 HALLIDAY AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63118-1102
Mailing Address - Country:US
Mailing Address - Phone:314-303-2528
Mailing Address - Fax:
Practice Address - Street 1:5825 SOUTHWEST AVE APT 7
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63139-1653
Practice Address - Country:US
Practice Address - Phone:314-303-2528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-04
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALICSW11406221041C0700X
PACW0259271041C0700X
MO20250054311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical