Provider Demographics
NPI:1215329701
Name:GATHERCOLE, QUINN MAKIA (LMHC)
Entity type:Individual
Prefix:
First Name:QUINN
Middle Name:MAKIA
Last Name:GATHERCOLE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:SABRINA
Other - Middle Name:LEE
Other - Last Name:HESSEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:280 CHESTNUT STREET
Mailing Address - Street 2:2ND FL
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1001
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:300 CAREW STREET
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-4945
Practice Address - Country:US
Practice Address - Phone:413-794-9816
Practice Address - Fax:413-794-4945
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11461101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health