Provider Demographics
NPI:1811342512
Name:QUINTON, WENDY (LSW, CAADC)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:
Last Name:QUINTON
Suffix:
Gender:F
Credentials:LSW, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 FRUIT FARM RD
Mailing Address - Street 2:
Mailing Address - City:ELYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17824-8902
Mailing Address - Country:US
Mailing Address - Phone:570-524-0909
Mailing Address - Fax:
Practice Address - Street 1:273 E 7TH ST
Practice Address - Street 2:
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-2853
Practice Address - Country:US
Practice Address - Phone:570-524-0909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-01
Last Update Date:2022-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW131679104100000X
PACAADC101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker