Provider Demographics
NPI:1609669118
Name:WHITING, QUINN (LAC)
Entity type:Individual
Prefix:
First Name:QUINN
Middle Name:
Last Name:WHITING
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3589 N SHILOH DR UNIT 341
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-5359
Mailing Address - Country:US
Mailing Address - Phone:479-466-6204
Mailing Address - Fax:
Practice Address - Street 1:1244 N WOODCREEK LN
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72701-8881
Practice Address - Country:US
Practice Address - Phone:479-409-1061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA1908020101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health