Provider Demographics
NPI:1215650106
Name:QUINN, SHAIENNA (LMSW, LCSW-A)
Entity type:Individual
Prefix:MS
First Name:SHAIENNA
Middle Name:
Last Name:QUINN
Suffix:
Gender:
Credentials:LMSW, LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 CABIN DR
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-7873
Mailing Address - Country:US
Mailing Address - Phone:231-903-8222
Mailing Address - Fax:
Practice Address - Street 1:208 CANDI LN STE B
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-8052
Practice Address - Country:US
Practice Address - Phone:803-542-6456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0201691041C0700X
SC154211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical