Provider Demographics
NPI:1427300698
Name:QUILES, YANITZA (LICSW)
Entity type:Individual
Prefix:MRS
First Name:YANITZA
Middle Name:
Last Name:QUILES
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1029 NORTH RD STE 24-10J
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-9711
Mailing Address - Country:US
Mailing Address - Phone:413-354-0445
Mailing Address - Fax:
Practice Address - Street 1:1029 NORTH RD STE 10
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-9715
Practice Address - Country:US
Practice Address - Phone:413-354-0445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-11
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1183811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty