Provider Demographics
NPI:1194061200
Name:QUIVEY, PATRICK EVERETT (LCSW)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:EVERETT
Last Name:QUIVEY
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 1:370 9TH ST
Mailing Address - Street 2:
Mailing Address - City:CRESCENT CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95531-3432
Mailing Address - Country:US
Mailing Address - Phone:707-464-4349
Mailing Address - Fax:
Practice Address - Street 1:370 9TH ST
Practice Address - Street 2:
Practice Address - City:CRESCENT CITY
Practice Address - State:CA
Practice Address - Zip Code:95531-3432
Practice Address - Country:US
Practice Address - Phone:707-464-4349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-17
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS157041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical