Healthcare Provider Details

I. General information

NPI: 1417479213
Provider Name (Legal Business Name): MAUREEN QUINN COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2017
Last Update Date: 07/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 MORGAN BLVD
VALPARAISO IN
46383-4836
US

IV. Provider business mailing address

4203 ONYX CT
VALPARAISO IN
46385-7301
US

V. Phone/Fax

Practice location:
  • Phone: 219-464-9495
  • Fax: 219-465-7169
Mailing address:
  • Phone: 219-246-9163
  • Fax: 219-465-7169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateIN

VIII. Authorized Official

Name: MRS. MAUREEN QUINN
Title or Position: OWNER
Credential: LCSW
Phone: 219-246-9163