Provider Demographics
NPI:1720145154
Name:QUINN, CONSTANCE ANN (LCSW-R, DSW)
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:ANN
Last Name:QUINN
Suffix:
Gender:F
Credentials:LCSW-R, DSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 8TH AVE
Mailing Address - Street 2:SUITE 810
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-5201
Mailing Address - Country:US
Mailing Address - Phone:212-624-1080
Mailing Address - Fax:917-591-6490
Practice Address - Street 1:111 8TH AVE
Practice Address - Street 2:SUITE 810
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-5201
Practice Address - Country:US
Practice Address - Phone:212-624-1080
Practice Address - Fax:917-591-6490
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY05616211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical