Provider Demographics
NPI:1124095187
Name:QUINN, ROBERT J (LCSW)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:J
Last Name:QUINN
Suffix:
Gender:M
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 90184
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27675-0184
Mailing Address - Country:US
Mailing Address - Phone:919-349-1515
Mailing Address - Fax:919-845-7900
Practice Address - Street 1:8504 SIX FORKS RD
Practice Address - Street 2:SUITE 201
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-2962
Practice Address - Country:US
Practice Address - Phone:919-349-1515
Practice Address - Fax:919-845-7900
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0026161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical