Provider Demographics
NPI:1881912087
Name:QUIGLEY-BURNS, MICHELLE LYNN (LCSW)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LYNN
Last Name:QUIGLEY-BURNS
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 1:231 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CRUM LYNNE
Mailing Address - State:PA
Mailing Address - Zip Code:19022-1020
Mailing Address - Country:US
Mailing Address - Phone:610-733-4091
Mailing Address - Fax:
Practice Address - Street 1:5 S STATE RD
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-2037
Practice Address - Country:US
Practice Address - Phone:610-352-6585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0162841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical