Provider Demographics
NPI:1700316197
Name:QUINN, EILEEN NICOLE (MS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:NICOLE
Last Name:QUINN
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4088 WINDHAVEN LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-2771
Mailing Address - Country:US
Mailing Address - Phone:479-981-0065
Mailing Address - Fax:
Practice Address - Street 1:4001 W 15TH ST STE 465
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5845
Practice Address - Country:US
Practice Address - Phone:972-396-4130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-18
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12958101YA0400X
TX76658101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)