Provider Demographics
NPI:1366511636
Name:QUAILE, COLLEEN (LMHC)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:QUAILE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:384 COHANNET ST
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-4103
Mailing Address - Country:US
Mailing Address - Phone:857-205-7031
Mailing Address - Fax:
Practice Address - Street 1:12 HARDING ST STE 206
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MA
Practice Address - Zip Code:02347-1232
Practice Address - Country:US
Practice Address - Phone:774-855-6974
Practice Address - Fax:774-855-9994
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5223101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health