Provider Demographics
NPI:1831521368
Name:QUINTON, ELLEN (LCSW)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:QUINTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1962
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40423-1962
Mailing Address - Country:US
Mailing Address - Phone:859-236-0853
Mailing Address - Fax:859-236-0854
Practice Address - Street 1:416 S 4TH ST
Practice Address - Street 2:STE. 1
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-2085
Practice Address - Country:US
Practice Address - Phone:859-236-0853
Practice Address - Fax:859-236-0854
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY37801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical