Provider Demographics
NPI:1538451679
Name:QUINLAN, NIAL PATRICK (PHD LPC NCC)
Entity type:Individual
Prefix:
First Name:NIAL
Middle Name:PATRICK
Last Name:QUINLAN
Suffix:
Gender:M
Credentials:PHD LPC NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 W 21ST ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23517-2246
Mailing Address - Country:US
Mailing Address - Phone:757-218-0305
Mailing Address - Fax:
Practice Address - Street 1:117 W 21ST ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23517-2246
Practice Address - Country:US
Practice Address - Phone:757-218-0305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-09
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004346101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional