MEDICARE: NELSON TONY QUINONES JR. MA, NCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1780487223
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NELSON TONY QUINONES JR. MA, NCC

Provider Business Mailing Address
First Line	:	390 STOVALL ST SE UNIT 1401
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30316-1533
Country	:	US
Telephone Number	:	470-582-6398
Fax Number	:

Provider Business Practice Location Address
First Line	:	390 STOVALL ST SE UNIT 1401
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30316-1533
Country	:	US
Telephone Number	:	470-582-6398
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2025
Last Update Date	:	03/31/2025

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