Provider Demographics
NPI:1558151142
Name:QUINN, THOMAS J (CASAC-T)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:J
Last Name:QUINN
Suffix:
Gender:
Credentials:CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:469 HORTON HWY
Mailing Address - Street 2:
Mailing Address - City:WILLISTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11596-2214
Mailing Address - Country:US
Mailing Address - Phone:516-850-2215
Mailing Address - Fax:
Practice Address - Street 1:469 HORTON HWY
Practice Address - Street 2:
Practice Address - City:WILLISTON PARK
Practice Address - State:NY
Practice Address - Zip Code:11596-2214
Practice Address - Country:US
Practice Address - Phone:516-850-2215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY37979101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)